Watanabe Akihiro, Yamashita Kimihiro, Takiguchi Gosuke, Urakawa Naoki, Hasegawa Hiroshi, Yamamoto Masashi, Kanaji Shingo, Matsuda Yoshiko, Matsuda Takeru, Oshikiri Taro, Nakamura Tetsu, Suzuki Satoshi, Kakeji Yoshihiro
Division of Gastrointestinal Surgery, Dept. of Surgery, Graduate School of Medicine, Kobe University.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2327-2329.
Neuroendocrine carcinomas in the right-side colon are rare. We report a case of neuroendocrine carcinoma occurring in the anastomotic site after ileocecal resection. The patient was a 55-year-old man who underwent ileocecal resection for adenocarcinoma in his appendix. Following surgery, he was administered adjuvant chemotherapy. Two and a half years after the surgery, he was diagnosedwith left ilium bone metastasis andreceivedrad iotherapy. After the radiotherapy, an anastomotic tumor andperitoneal metastasis were found. He was administeredFOLFIRI but couldnot tolerate the therapy. After changing to FOLFOX therapy, he reportedabd ominal pain from perforation of the anastomotic tumor, which was not improvedby antibiotics. Therefore, he was referredto our hospital for surgery. The surgery includedresection of part of the anastomosis. Histopathological examination showed that the tumor at the anastomosis was not adenocarcinoma but rather neuroendocrine carcinoma. After discharge, the patient started a new chemotherapy regimen(CDDP plus VP-16). This case indicates that resection of the recurrence site may leadto new treatment, improve patient' QOL, andextendthe life prognosis.
右侧结肠神经内分泌癌较为罕见。我们报告一例回盲部切除术后吻合口处发生神经内分泌癌的病例。患者为一名55岁男性，因阑尾腺癌接受了回盲部切除术。术后，他接受了辅助化疗。手术两年半后，他被诊断为左髂骨转移并接受了放疗。放疗后，发现吻合口肿瘤及腹膜转移。他接受了FOLFIRI治疗，但无法耐受该治疗。更换为FOLFOX治疗后，他报告因吻合口肿瘤穿孔出现腹痛，使用抗生素治疗后无改善。因此，他被转诊至我院接受手术。手术包括切除部分吻合口。组织病理学检查显示，吻合口处的肿瘤并非腺癌，而是神经内分泌癌。出院后，患者开始了新的化疗方案（顺铂加依托泊苷）。该病例表明，切除复发部位可能带来新的治疗方法，改善患者生活质量，并延长生命预后。
