Ferrante M, Van Boxelaer I, De Man M, Schelfout A M, Van Molhem Y, Hendrickx K, Vandervoort J, Van Der Spek P, Sermon F, Du Ville L, Lepoutre L
Department of Gastroenterology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.
Acta Gastroenterol Belg. 2010 Jul-Sep;73(3):397-402.
A second primary malignancy (SPM) is frequently reported in patients with a gastrointestinal neuroendocrine tumour (NET). The majority of SPM are located in the gastrointestinal tract, but malignancies at other sites are described as well. This phenomenon might just be coincidental due to high incidence rates of asymptomatic NET lesions in patients who are operated or who undergo autopsy for another primary malignancy. However, other theories have been developed since the observed incidences rates seem to be double as high as expected. Some authors suggest a common genetic predisposition, while others report tumourigenic properties of various neuroendocrine peptides, including secretin, gastrin and cholecystokinin. This review is illustrated by a case report of a patient in whom the radiological diagnosis of a diffuse liver metastasized adenocarcinoma of the rectum changed dramatically after positron emission tomography and explorative laparoscopy to a curable adenocarcinoma of the rectum with a simultaneous well-differentiated neuroendocrine carcinoma.
胃肠道神经内分泌肿瘤（NET）患者中经常报告有第二原发性恶性肿瘤（SPM）。大多数SPM位于胃肠道，但其他部位的恶性肿瘤也有相关描述。这种现象可能只是巧合，因为接受手术或因另一种原发性恶性肿瘤接受尸检的患者中无症状NET病变的发病率很高。然而，由于观察到的发病率似乎是预期的两倍，因此也提出了其他理论。一些作者认为存在共同的遗传易感性，而另一些作者则报告了各种神经内分泌肽（包括促胰液素、胃泌素和胆囊收缩素）的致瘤特性。本综述通过一例患者的病例报告进行说明，该患者最初经放射学诊断为弥漫性肝转移的直肠腺癌，在正电子发射断层扫描和探索性腹腔镜检查后，戏剧性地转变为可治愈的直肠腺癌，同时伴有高分化神经内分泌癌。
