Abstract:
Large cell neuroendocrine carcinoma (LCNEC) is an extremely rare malignant tumor of the colon, presenting with more severe clinical outcomes in comparison to colonic adenocarcinoma. There are very few reported cases in the literature. We hereby add our voice to the incidence of this disease by presenting the first report of a patient with ileocolic intussusception secondary to a large cell neuroendocrine cancer of the cecum. The patient was a 48-year-old woman who presented with acute onset of generalized abdominal pain and leukocytosis. CT scan revealed an ileocecal intussusception and multiple liver metastases suggestive of a malignant bowel lesion. She underwent emergency surgery, and an extended right hemicolectomy with ileo-transverse anastomosis was performed. Histology of the resected lesion revealed large cell neuroendocrine carcinoma of the cecum with invasion through the muscularis propria into peri colorectal tissues. The tumor retained mismatch repair (MMR) proteins with low potential for microsatellite instability (MSI). With a clinical diagnosis of stage IV LCNEC, the patient began platinum doublet chemotherapy with carboplatin and etoposide; however, her disease progressed, and the patient expired within a few months after her diagnosis. Clinical diagnosis of adult intussusception should prompt clinicians to rule out malignant etiology. This patient had a large cell neuroendocrine carcinoma of the colon, a rare and extremely aggressive malignancy. Patients with LCNEC will benefit from a multidisciplinary approach to treatment.
摘要:
年夜细胞神经内分泌癌(LCNEC)是一种罕见的结肠恶性肿瘤,与结肠腺癌相比,临床结局更严重。文献中报道的病例很少。在此,我们通过介绍盲肠大细胞神经内分泌癌继发回肠肠套叠患者的第一份报告,为这种疾病的发病率增加了声音。该患者是一名48岁的女性,其表现为急性发作的全身性腹痛和白细胞增多。CT扫描显示回盲肠套叠和多发性肝转移,提示恶性肠病变。她接受了紧急手术,并进行了扩大的右半结肠切除术,并进行了回肠横向吻合术。切除病变的组织学显示,盲肠大细胞神经内分泌癌通过固有肌层侵入结直肠周围组织。肿瘤保留的错配修复(MMR)蛋白具有低的微卫星不稳定性(MSI)潜力。临床诊断为IV期LCNEC,患者开始使用卡铂和依托泊苷进行铂双联化疗;然而,她的病进展了,病人在确诊后几个月内就过期了.成人肠套叠的临床诊断应提示临床医生排除恶性病因。该患者患有结肠大细胞神经内分泌癌,一种罕见且极具侵袭性的恶性肿瘤。LCNEC患者将受益于多学科治疗方法。