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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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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 |
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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 |
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