直肠神经内分泌肿瘤原发切除术后15年发现肝转移。

Liver metastasis from rectal neuroendocrine neoplasm detected 15 years after primary resection.

作者信息

Akabane Miho, Okubo Satoshi, Kinowaki Keiichi, Matsumura Masaru, Shindoh Junichi, Hashimoto Masaji

机构信息

Hepatobiliary-Pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minatoku, Tokyo, 105-8470, Japan.

Okinaka Memorial Institute for Medical Disease, Tokyo, Japan.

出版信息

Surg Case Rep. 2022 Dec 2;8(1):212. doi: 10.1186/s40792-022-01569-5.

DOI:10.1186/s40792-022-01569-5

PMID:36459257

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9718905/

Abstract

BACKGROUND

Rectal neuroendocrine neoplasms can induce liver metastasis. However, few reports exist on the associated long-term recurrence rates. We report a case of liver metastasis identified 15 years after rectal neuroendocrine neoplasm resection.

CASE PRESENTATION

A 50-year-old woman was on semi-annual follow-up after undergoing mastectomy for breast cancer (pT1N0M0) and low anterior resection for grade 1 rectal neuroendocrine neoplasm (pT1b, ly1, v1). Fifteen years postoperatively, a 7-mm hyperechoic mass was identified at liver segment 6. Magnetic resonance imaging revealed a slight growth of the mass. Positron emission tomography/computed tomography revealed radiotracer accumulation in the lesion. Laparoscopic hepatectomy was performed. The histopathological diagnosis was grade 2 neuroendocrine neoplasm. The pathological findings and clinical course indicated the tumor originated in the rectum.

CONCLUSIONS

Our findings highlight the need to reassess the optimal postoperative follow-up period for patients with rectal neuroendocrine neoplasm.

摘要

背景

直肠神经内分泌肿瘤可发生肝转移。然而，关于其相关长期复发率的报道较少。我们报告1例直肠神经内分泌肿瘤切除术后15年出现肝转移的病例。

病例介绍

一名50岁女性在接受乳腺癌（pT1N0M0）乳房切除及1级直肠神经内分泌肿瘤（pT1b，ly1，v1）低位前切除术后，每半年进行一次随访。术后15年，在肝6段发现一个7毫米的高回声肿块。磁共振成像显示肿块略有增大。正电子发射断层扫描/计算机断层扫描显示病变处有放射性示踪剂聚集。遂行腹腔镜肝切除术。组织病理学诊断为2级神经内分泌肿瘤。病理结果和临床病程表明肿瘤起源于直肠。