Large Cell Neuroendocrine Carcinoma of the Colon With Carcinomatosis Peritonei.
- Author:
Jang Jin KIM
1
;
Sung Su PARK
;
Taek Gu LEE
;
Ho Chang LEE
;
Sang Jeon LEE
Author Information
- Publication Type:Case Report
- Keywords: Large-cell neuroendocrine carcinoma; Colon; Peritoneal carcinomatosis
- MeSH: Abdominal Pain; Adenocarcinoma; Aged; Biopsy; Carcinoma*; Carcinoma, Neuroendocrine*; Colon*; Colon, Sigmoid; Diarrhea; Drug Therapy; Gastrointestinal Hemorrhage; Humans; Immunohistochemistry; Neoplasm Metastasis; Peritoneal Lavage; Prognosis; Recurrence; Synaptophysin
- From:Annals of Coloproctology 2018;34(4):222-225
- CountryRepublic of Korea
- Language:English
- Abstract: Colorectal large-cell neuroendocrine carcinomas (NECs) are extremely rare and have very poor prognosis compared to adenocarcinomas. A 74-year-old man presented with abdominal pain, diarrhea and hematochezia. The histopathologic report of colonoscopic biopsy performed at a local clinic was a poorly differentiated carcinoma. An abdominopelvic computed scan revealed irregularly enhanced wall thickening at the sigmoid colon with regional fat stranding and lymphnode enlargement. He underwent a laparoscopic high anterior resection with selective peritonectomy for peritoneal carcinomatosis, intraoperative peritoneal irrigation chemotherapy, and early postoperative intraperitoneal chemotherapy for 5 days. The tumor had a high proliferation rate (mitotic count > 50/10 HPFs and 90% of the Ki-67 index) and lymph-node metastases had occurred. On immunohistochemistry, the tumor cells expressed CD56 and synaptophysin. Large-cell NEC was confirmed. Systemic chemotherapy with cisplatin/etoposide was done. The patient is still alive after 3 years with no evidence of recurrence.
