Mixed Adenoneuroendocrine Carcinoma of the Colon Progressed Rapidly After Hepatic Rupture: Report of a Case
- 1 January 2014
- journal article
- case report
- Published by International College of Surgeons in International Surgery
- Vol. 99 (1), 40-44
- https://doi.org/10.9738/intsurg-d-13-00161.1
Abstract
The rupture of a metastatic mixed adenoneuroendocrine carcinoma (MANEC) has not been previously reported, although the neuroendocrine cell carcinoma is often associated with a high incidence of hepatic metastases. The patient was a 39-year-old male who presented with upper abdominal pain over 3 months. Computed tomography showed multiple tumors in both hepatic lobes, while lower gastrointestinal endoscopy revealed a tumor in the transverse colon. Histopathologic examination of the tumor revealed it to be a neuroendocrine cell carcinoma. After the resection of the primary tumor, hepatic metastases rapidly increased, and one of them in the left lateral segment was ruptured with significant hemorrhage. The rupture led us to undertake the emergency operation to stop the bleeding. Histology showed a high-grade large-cell neuroendocrine carcinoma associated with moderately differentiated tubular adenocarcinoma. The Ki-67 labeling index was 80% (G3). The diagnosis was mixed adenoneuroendocrine carcinoma according to the 2010 World Health Organization guidelines. Hepatic arterial infusion chemotherapy, systemic chemotherapy, and transcatheter arterial chemoembolization did not decrease the tumor progress, and the patient died on postoperative day 110. Reporting this highly malignant case, I hope all doctors can be interested in MANEC.Keywords
This publication has 12 references indexed in Scilit:
- Colorectal Poorly Differentiated Neuroendocrine Carcinomas and Mixed Adenoneuroendocrine CarcinomasThe American Journal of Surgical Pathology, 2012
- Mixed Adenoneuroendocrine Carcinomas (MANECs) of the Gastrointestinal Tract: An UpdateCancers, 2012
- [A long-term survival case of neuroendocrine tumor of the sigmoid colon with multiple liver metastases].2011
- Mixed adenoneuroendocrine carcinoma (MANEC) of the gallbladder: A possible stem cell tumor?Pathology International, 2011
- [Pathology of carcinoid tumors (neuroendocrine tumors)].2011
- A CASE OF LONG-TERM SURVIVAL AFTER CHEMOTHERAPY FOR LIVER METASTASES FROM ENDOCRINE CELL CARCINOMA OF THE COLONNihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association), 2008
- Clinicopathological Study of Rare Histological Types of Colorectal Cancer-Multi-Institutional Questionnaire Study-Nihon Daicho Komonbyo Gakkai Zasshi, 2004
- Guidelines for the Diagnosis and Treatment of Neuroendocrine Gastrointestinal TumoursNeuroendocrinology, 2004
- Clinicopathological Study of Poorly Differentiated and Undifferentiated Carcinoma of the Large Intestine. Classification and Special Reference to the Endocrine Cell Carcinoma.The Japanese Journal of Gastroenterological Surgery, 1992
- Carcinoid Tumors and the Mixed (Composite) Glandular-Endocrine Cell CarcinomasThe American Journal of Surgical Pathology, 1987