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KMID : 1141920180340040222
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Annals of Coloproctology
2018 Volume.34 No. 4 p.222 ~ p.225
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Large Cell Neuroendocrine Carcinoma of the Colon With Carcinomatosis Peritonei
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Kim Jang-Jin
Park Sung-Su
Lee Taek-Gu
Lee Ho-Chang
Lee Sang-Jeon
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Abstract
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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.
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KEYWORD
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Large-cell neuroendocrine carcinoma, Colon, Peritoneal carcinomatosis
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