A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis
Abstract 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...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-12-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-020-01069-4 |
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| author | Kunihiko Suga Hiroomi Ogawa Makoto Sohda Chika Katayama Naoya Ozawa Katsuya Osone Takuhisa Okada Takuya Shiraishi Ryuji Katoh Akihiko Sano Makoto Sakai Takehiko Yokobori Ken Shirabe Hiroshi Saeki |
| author_facet | Kunihiko Suga Hiroomi Ogawa Makoto Sohda Chika Katayama Naoya Ozawa Katsuya Osone Takuhisa Okada Takuya Shiraishi Ryuji Katoh Akihiko Sano Makoto Sakai Takehiko Yokobori Ken Shirabe Hiroshi Saeki |
| author_sort | Kunihiko Suga |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-19T06:47:02Z |
| format | Article |
| id | doaj.art-559497be51084227b21474bcadd6c5f5 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-19T06:47:02Z |
| publishDate | 2020-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-559497be51084227b21474bcadd6c5f52022-12-21T20:31:53ZengSpringerOpenSurgical Case Reports2198-77932020-12-01611610.1186/s40792-020-01069-4A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosisKunihiko Suga0Hiroomi Ogawa1Makoto Sohda2Chika Katayama3Naoya Ozawa4Katsuya Osone5Takuhisa Okada6Takuya Shiraishi7Ryuji Katoh8Akihiko Sano9Makoto Sakai10Takehiko Yokobori11Ken Shirabe12Hiroshi Saeki13Department of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityDivision of Integrated Oncology Research, Gunma University Initiative for Advanced Research (GIAR)Department of General Surgical Science, Graduate School of Medicine, Gunma UniversityDepartment of General Surgical Science, Graduate School of Medicine, Gunma UniversityAbstract 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.https://doi.org/10.1186/s40792-020-01069-4Large cell neuroendocrine carcinomaNeuroendocrine tumor of the colonLCNEC |
| spellingShingle | Kunihiko Suga Hiroomi Ogawa Makoto Sohda Chika Katayama Naoya Ozawa Katsuya Osone Takuhisa Okada Takuya Shiraishi Ryuji Katoh Akihiko Sano Makoto Sakai Takehiko Yokobori Ken Shirabe Hiroshi Saeki A case of colorectal large cell neuroendocrine carcinoma accompanied by disseminated peritoneal leiomyomatosis Surgical Case Reports Large cell neuroendocrine carcinoma Neuroendocrine tumor of the colon LCNEC |
| 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 | Large cell neuroendocrine carcinoma Neuroendocrine tumor of the colon LCNEC |
| url | https://doi.org/10.1186/s40792-020-01069-4 |
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