Morimoto Koichiro, Kuwabara Hiroshi, Ryu Kyoko, Sato Taku, Sanada Takahiro, Nakamura Noriaki, Goseki Narihide
Dept. of Surgery, Shuuwa General Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2189-2191.
We report 2 cases of neuroendocrine carcinoma(NEC)of colon and rectum with distant metastasis. The treatment of NEC with distant metastasis is based on the treatment of small cell lung cancer, but that is controversial because NEC is relatively rare. Case 1: A 75-year-old man who was admitted for anal pain. Physical examination showed the anal tumor and swelling inguinal lymph nodes. CT showed rectum tumor and multiple lymph node metastases to the pelvis and inguinal region. Colonoscopy showed a Type 3 tumor in the rectum. He was diagnosed with NEC based on biopsy and immunostaining. Colostomy was performed for pain relief and etoposide/cisplatin(EP)therapy was introduced. After 6 courses of the chemotherapy, CT showed progression of the tumor, then we made the shift to palliative treatment. Case 2: A 69-year-old man who was admitted for abdominal pain and back pain. CT showed transverse colon tumor with multiple metastases to the liver, lung, and lymph nodes. Colonoscopy showed a circumferential tumor in the transverse colon. He was diagnosed with NEC based on biopsy and immunostaining. He refused chemotherapy and died 2 months later.
我们报告2例伴有远处转移的结肠和直肠神经内分泌癌(NEC)。伴有远处转移的NEC的治疗基于小细胞肺癌的治疗方法,但由于NEC相对罕见,这存在争议。病例1:一名75岁男性因肛门疼痛入院。体格检查发现肛门肿物及腹股沟淋巴结肿大。CT显示直肠肿瘤以及盆腔和腹股沟区多发淋巴结转移。结肠镜检查显示直肠有3型肿瘤。经活检和免疫染色,他被诊断为NEC。为缓解疼痛进行了结肠造口术,并采用依托泊苷/顺铂(EP)方案化疗。化疗6个疗程后,CT显示肿瘤进展,随后转为姑息治疗。病例2:一名69岁男性因腹痛和背痛入院。CT显示横结肠癌伴肝、肺及淋巴结多发转移。结肠镜检查显示横结肠有环形肿瘤。经活检和免疫染色,他被诊断为NEC。他拒绝化疗,2个月后死亡。