Cargando…

A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis

BACKGROUND: Neuroendocrine carcinomas (NECs) of the colon are among the rarest types of colorectal cancers. Among these, large cell type neuroendocrine carcinoma (LCNEC) is particularly rare. Colorectal NEC is an aggressive disease, and there are few reports of long-term survivors. Here, we report a...

Descripción completa

Detalles Bibliográficos
Autores principales: Suga, Kunihiko, Ogawa, Hiroomi, Sohda, Makoto, Katayama, Chika, Ozawa, Naoya, Osone, Katsuya, Okada, Takuhisa, Shiraishi, Takuya, Katoh, Ryuji, Sano, Akihiko, Sakai, Makoto, Yokobori, Takehiko, Shirabe, Ken, Saeki, Hiroshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726067/
https://www.ncbi.nlm.nih.gov/pubmed/33296060
http://dx.doi.org/10.1186/s40792-020-01069-4
_version_ 1783620808252325888
author Suga, Kunihiko
Ogawa, Hiroomi
Sohda, Makoto
Katayama, Chika
Ozawa, Naoya
Osone, Katsuya
Okada, Takuhisa
Shiraishi, Takuya
Katoh, Ryuji
Sano, Akihiko
Sakai, Makoto
Yokobori, Takehiko
Shirabe, Ken
Saeki, Hiroshi
author_facet Suga, Kunihiko
Ogawa, Hiroomi
Sohda, Makoto
Katayama, Chika
Ozawa, Naoya
Osone, Katsuya
Okada, Takuhisa
Shiraishi, Takuya
Katoh, Ryuji
Sano, Akihiko
Sakai, Makoto
Yokobori, Takehiko
Shirabe, Ken
Saeki, Hiroshi
author_sort Suga, Kunihiko
collection PubMed
description BACKGROUND: Neuroendocrine carcinomas (NECs) of the colon are among the rarest types of colorectal cancers. Among these, large cell type neuroendocrine carcinoma (LCNEC) is particularly rare. Colorectal NEC is an aggressive disease, and there are few reports of long-term survivors. Here, we report a case of LCNEC accompanied by disseminated peritoneal leiomyomatosis that was difficult to diagnose. CASE PRESENTATION: The case involves a 62-year-old female found to be positive for fecal occult blood by medical examination. An endoscopy revealed a tumor in the ascending colon, and the biopsy revealed poorly differentiated cancer. Abnormal FDG accumulation with peritoneal thickening was visible on 18F-fluorodeoxyglucose positron-emission tomography (FDG-PET) and suspected to be peritoneal dissemination. Laparoscopic ileocecal resection was performed for the tumor of the ascending colon with abdominal wall invasion. At that time, numerous intra-abdominal nodules were observed, indicating peritoneal dissemination. The pathological diagnosis of the primary lesion was LCNEC, and the patient requested to undergo total peritoneal resection. After one course of chemotherapy with irinotecan plus cisplatin, she underwent total peritoneal resection, uterine annex resection, left inguinal lymph node resection, and intra-abdominal hyperthermic intraperitoneal chemotherapy with mitomycin C. Because a postoperative pathological examination revealed that the intra-abdominal nodules were leiomyomas, we diagnosed the patient with disseminated peritoneal leiomyomatosis. The left inguinal lymph node was diagnosed with a metastatic tumor. In summary, the final diagnosis was LCNEC in the ascending colon with inguinal lymph node metastasis. Postoperative chemotherapy has been administered to date. She is currently 18 months post-primary surgery and 15 months post-peritonectomy without apparent recurrence or metastatic findings. CONCLUSION: We experienced a case of Stage IVa colorectal LCNEC accompanied by disseminated peritoneal leiomyomatosis. Although the prognosis is generally poor, multidisciplinary treatment for advanced colorectal LCNEC may result in a favorable outcome for some patients. If peritoneal dissemination is suspected during operation, sampling of the nodule to confirm the pathological diagnosis is advisable.
format Online
Article
Text
id pubmed-7726067
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-77260672020-12-17 A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis Suga, Kunihiko Ogawa, Hiroomi Sohda, Makoto Katayama, Chika Ozawa, Naoya Osone, Katsuya Okada, Takuhisa Shiraishi, Takuya Katoh, Ryuji Sano, Akihiko Sakai, Makoto Yokobori, Takehiko Shirabe, Ken Saeki, Hiroshi Surg Case Rep Case Report BACKGROUND: Neuroendocrine carcinomas (NECs) of the colon are among the rarest types of colorectal cancers. Among these, large cell type neuroendocrine carcinoma (LCNEC) is particularly rare. Colorectal NEC is an aggressive disease, and there are few reports of long-term survivors. Here, we report a case of LCNEC accompanied by disseminated peritoneal leiomyomatosis that was difficult to diagnose. CASE PRESENTATION: The case involves a 62-year-old female found to be positive for fecal occult blood by medical examination. An endoscopy revealed a tumor in the ascending colon, and the biopsy revealed poorly differentiated cancer. Abnormal FDG accumulation with peritoneal thickening was visible on 18F-fluorodeoxyglucose positron-emission tomography (FDG-PET) and suspected to be peritoneal dissemination. Laparoscopic ileocecal resection was performed for the tumor of the ascending colon with abdominal wall invasion. At that time, numerous intra-abdominal nodules were observed, indicating peritoneal dissemination. The pathological diagnosis of the primary lesion was LCNEC, and the patient requested to undergo total peritoneal resection. After one course of chemotherapy with irinotecan plus cisplatin, she underwent total peritoneal resection, uterine annex resection, left inguinal lymph node resection, and intra-abdominal hyperthermic intraperitoneal chemotherapy with mitomycin C. Because a postoperative pathological examination revealed that the intra-abdominal nodules were leiomyomas, we diagnosed the patient with disseminated peritoneal leiomyomatosis. The left inguinal lymph node was diagnosed with a metastatic tumor. In summary, the final diagnosis was LCNEC in the ascending colon with inguinal lymph node metastasis. Postoperative chemotherapy has been administered to date. She is currently 18 months post-primary surgery and 15 months post-peritonectomy without apparent recurrence or metastatic findings. CONCLUSION: We experienced a case of Stage IVa colorectal LCNEC accompanied by disseminated peritoneal leiomyomatosis. Although the prognosis is generally poor, multidisciplinary treatment for advanced colorectal LCNEC may result in a favorable outcome for some patients. If peritoneal dissemination is suspected during operation, sampling of the nodule to confirm the pathological diagnosis is advisable. Springer Berlin Heidelberg 2020-12-09 /pmc/articles/PMC7726067/ /pubmed/33296060 http://dx.doi.org/10.1186/s40792-020-01069-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Case Report
Suga, Kunihiko
Ogawa, Hiroomi
Sohda, Makoto
Katayama, Chika
Ozawa, Naoya
Osone, Katsuya
Okada, Takuhisa
Shiraishi, Takuya
Katoh, Ryuji
Sano, Akihiko
Sakai, Makoto
Yokobori, Takehiko
Shirabe, Ken
Saeki, Hiroshi
A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis
title A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis
title_full A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis
title_fullStr A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis
title_full_unstemmed A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis
title_short A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis
title_sort case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726067/
https://www.ncbi.nlm.nih.gov/pubmed/33296060
http://dx.doi.org/10.1186/s40792-020-01069-4
work_keys_str_mv AT sugakunihiko acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT ogawahiroomi acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT sohdamakoto acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT katayamachika acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT ozawanaoya acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT osonekatsuya acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT okadatakuhisa acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT shiraishitakuya acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT katohryuji acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT sanoakihiko acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT sakaimakoto acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT yokoboritakehiko acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT shirabeken acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT saekihiroshi acaseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT sugakunihiko caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT ogawahiroomi caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT sohdamakoto caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT katayamachika caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT ozawanaoya caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT osonekatsuya caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT okadatakuhisa caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT shiraishitakuya caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT katohryuji caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT sanoakihiko caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT sakaimakoto caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT yokoboritakehiko caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT shirabeken caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis
AT saekihiroshi caseofcolorectallargecellneuroendocrinecarcinomaaccompaniedbydisseminatedperitonealleiomyomatosis