Goksoy B, Tosun Y, Gunay M Ozgur
Department of General Surgery, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkey.
Department of Pathology, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkey.
J Clin Transl Res. 2022 Jun 17;8(4):272-275. eCollection 2022 Aug 29.
Large cell neuroendocrine carcinomas (LCNEC) of the colon are an extremely rare and aggressive type of colorectal cancer. While multifocality is more frequently seen in small intestine NECs, no cases of multifocal NEC of the colon have been reported before.
A 69-year-old male patient presented with abdominal pain. Colonoscopy revealed a necrotic-polypoid mass in the sigmoid colon and the biopsy result was reported as malignant epithelial tumor. Laparoscopic anterior resection was performed with the preliminary diagnosis of colon adenocarcinoma. Histopathological examination revealed three polypoid tumors, the largest of which was 4 cm, in the sigmoid colon. Immunohistochemical examination showed positivity for synaptophysin, chromogranin, and CDX2. High Ki67 proliferation index, high mitosis, and widespread p53 expression were observed in all tumors. With these findings, a diagnosis of multifocal large cell NEC was made. To the best of our knowledge, this is the first report describing a case of multifocal large cell NEC of the colon.
LCNECs of the colon are very aggressive. Here, we report for the first time a case of multifocal LCNEC. In a short period of 1 month after the surgery, new widespread metastases were detected in the liver. Therefore, these tumors should be followed more closely than usual for early treatment.
结肠大细胞神经内分泌癌（LCNEC）是一种极其罕见且侵袭性强的结直肠癌类型。虽然多灶性在小肠神经内分泌癌中更常见，但此前尚无结肠多灶性神经内分泌癌的病例报道。
一名69岁男性患者因腹痛就诊。结肠镜检查发现乙状结肠有一个坏死性息肉样肿物，活检结果报告为恶性上皮性肿瘤。初步诊断为结肠腺癌，遂行腹腔镜前切除术。组织病理学检查显示乙状结肠有三个息肉样肿瘤，最大的直径为4厘米。免疫组化检查显示突触素、嗜铬粒蛋白和CDX2呈阳性。所有肿瘤均观察到高Ki67增殖指数、高有丝分裂率和广泛的p53表达。基于这些发现，诊断为多灶性大细胞神经内分泌癌。据我们所知，这是首例描述结肠多灶性大细胞神经内分泌癌病例的报告。
结肠LCNEC具有很强的侵袭性。在此，我们首次报告一例多灶性LCNEC病例。术后短短1个月内，在肝脏发现了新的广泛转移灶。因此，应对这些肿瘤进行比常规更密切的随访以便早期治疗。
