Stoner Patrick, Ghaffaripour Taban, Cohen David
Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
Department of Pathology, Mount Sinai Medical Center, Miami Beach, Florida, USA.
BMJ Case Rep. 2017 Aug 7;2017:bcr-2017-220093. doi: 10.1136/bcr-2017-220093.
Colonic inflammation seen in inflammatory bowel disease (IBD) predisposes to the development of colorectal adenocarcinoma. In contrast, colorectal neuroendocrine carcinomas (NECs) have rarely been reported in the setting of IBD, and no definitive relationship between these tumours and IBD has been established. Dysplasia from chronic inflammation leading to neuroendocrine cell differentiation may be responsible for NEC development, though this finding has not been seen consistently. We present a case of large-cell neuroendocrine carcinoma of the sigmoid colon in a 65-year-old woman with long-standing ulcerative colitis. Although she underwent regular endoscopic follow-ups and was receiving the tumour necrosis factor alpha inhibitor infliximab, her tumour was large and aggressive, with metastases to the liver discovered at time of diagnosis. This case highlights the aggressive nature and poor prognosis of NECs and stresses the need to identify patients at high risk of developing NECs and develop improved surveillance guidelines for detecting them.
炎症性肠病（IBD）中所见的结肠炎症易引发结直肠癌。相比之下，结直肠神经内分泌癌（NEC）在IBD背景下鲜有报道，且这些肿瘤与IBD之间尚未确立明确关系。慢性炎症导致神经内分泌细胞分化的发育异常可能是NEC发生的原因，尽管这一发现并不一致。我们报告一例65岁患有长期溃疡性结肠炎的女性乙状结肠大细胞神经内分泌癌病例。尽管她接受了定期内镜随访并接受肿瘤坏死因子α抑制剂英夫利昔单抗治疗，但她的肿瘤体积大且侵袭性强，诊断时已发现肝转移。该病例凸显了NEC的侵袭性本质和不良预后，并强调需要识别出发生NEC高风险的患者并制定改进的监测指南以检测此类肿瘤。
