Kanazawa Yuji, Kikuchi Masahiro, Imai Yukihiro, Katakami Nobuyuki, Kaihara Satoshi, Shinohara Shogo
Department of Otolaryngology, Head and Neck Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minami-machi, Chuo-ku, Kobe 650-0047, Japan.
Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Case Rep Otolaryngol. 2020 Feb 13;2020:5927610. doi: 10.1155/2020/5927610. eCollection 2020.
Patients with mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) of the colon have poor prognosis. Herein, we report a patient with MiNEN of the colon with metastases to the liver and the thyroid gland, with long-term survival. A 45-year-old man presented with anterior neck swelling. Histopathological examination of the thyroid tumor revealed neuroendocrine carcinoma (NEC), suggesting that a primary NEC in another organ had metastasized to the thyroid gland. Computed tomography to identify a primary NEC revealed two tumors: one in the liver and one in the transverse colon. A biopsy revealed that the histopathology of the liver and colon tumors was NEC and adenocarcinoma, respectively. Thereafter, the patient underwent surgical resection of the colon tumor and was finally diagnosed as colon MiNEN with metastases to the thyroid and liver. The surgical resection of the metastatic liver tumor was performed after several courses of systemic chemotherapy, and the patient survives presently without any recurrence for approximately seven years after the diagnosis. Surgical resection of each metastatic lesion combined with systematic chemotherapy apparently improved the prognosis of MiNEN of the colon with distant metastases.
结肠混合性神经内分泌-非神经内分泌肿瘤（MiNENs）患者预后较差。在此，我们报告一例发生肝和甲状腺转移的结肠MiNEN患者，其长期存活。一名45岁男性因前颈部肿胀就诊。甲状腺肿瘤的组织病理学检查显示为神经内分泌癌（NEC），提示其他器官的原发性NEC转移至甲状腺。为确定原发性NEC而进行的计算机断层扫描发现了两个肿瘤：一个在肝脏，一个在横结肠。活检显示肝肿瘤和结肠肿瘤的组织病理学分别为NEC和腺癌。此后，患者接受了结肠肿瘤的手术切除，最终被诊断为伴有甲状腺和肝转移的结肠MiNEN。在进行了几个疗程的全身化疗后，对转移性肝肿瘤进行了手术切除，目前患者在诊断后约7年无任何复发存活。对每个转移灶进行手术切除并结合全身化疗明显改善了伴有远处转移的结肠MiNEN的预后。
