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Large Cell Neuroendocrine Carcinoma of the Colon With Carcinomatosis Peritonei

Annals of Coloproctology 2018년 34권 4호 p.222 ~ 225
김장진 ( Kim Jang-Jin ) - Chungbuk National University Hospital Department of Surgery

박성수 ( Park Sung-Su ) - Chungbuk National University Hospital Department of Surgery
이택구 ( Lee Taek-Gu ) - Chungbuk National University Hospital Department of Surgery
이호창 ( Lee Ho-Chang ) - Chungbuk National University College of Medicine Department of Pathology
이상전 ( Lee Sang-Jeon ) - Chungbuk National University College of Medicine Department of Surgery

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.

키워드

Large-cell neuroendocrine carcinoma; Colon; Peritoneal carcinomatosis
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