Ann Coloproctol.  2018 Aug;34(4):222-225. 10.3393/ac.2018.02.27.

Large Cell Neuroendocrine Carcinoma of the Colon With Carcinomatosis Peritonei

• Kim JJ
• Park SS
• Lee TG
• Lee HC
• Lee SJ

• KMID: 2422085
• DOI: http://doi.org/10.3393/ac.2018.02.27

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.

Keyword

Large-cell neuroendocrine carcinoma; Colon; Peritoneal carcinomatosis

MeSH Terms

Abdominal Pain
Adenocarcinoma
Aged
Biopsy
Carcinoma*
Carcinoma, Neuroendocrine*
Colon*
Colon, Sigmoid
Diarrhea
Drug Therapy
Gastrointestinal Hemorrhage
Humans
Immunohistochemistry
Neoplasm Metastasis
Peritoneal Lavage
Prognosis
Recurrence
Synaptophysin
Synaptophysin