Bustamante-Lopez Leonardo Alfonso, Allawi Ahmed, Yu David, Devane Liam, Kelly Justin, Garcia-Henriquez Norbert, Monson John R T
Surgical Health Outcomes Consortium (SHOC), Digestive Health and Surgery Institute, AdventHealth, Orlando, FL, USA.
Transl Cancer Res. 2023 Mar 31;12(3):658-662. doi: 10.21037/tcr-22-2270. Epub 2023 Mar 22.
Neuroendocrine tumors of the small intestine are uncommon, but at the same time they are the most frequent subtype of neuroendocrine tumor in the gastrointestinal system. They originate from enterochromaffin cells, which are involved in the creation of serotonin. This asymptomatic characteristic in the initial presentation is usually why these tumors are discovered at a late stage, sometimes in association with symptomatic metastatic disease.
We present a case-report of a 52-year-old gentleman with a suggestive family history of hereditary cancer syndrome (mother with lung cancer and maternal uncle with colon cancer at the age of 40 years old). The patient was diagnosed with rectal cancer and he received neoadjuvant chemotherapy with short-course radiotherapy followed by a robotic low anterior resection with diverting loop ileostomy. Following closure of his ileostomy, the pathology report of the ileostomy resection specimen showed a 1.1 cm neuroendocrine tumor with negative margins.
This extraordinary unusual presentation could be very fortuity for the patient, who in every other opportunity just found this neuroendocrine tumor after advanced or maybe metastatic diseases.
小肠神经内分泌肿瘤并不常见，但同时它们是胃肠系统中最常见的神经内分泌肿瘤亚型。它们起源于肠嗜铬细胞，这些细胞参与血清素的产生。初始表现时的无症状特征通常是这些肿瘤在晚期才被发现的原因，有时还伴有有症状的转移性疾病。
我们报告一例52岁男性病例，其有提示遗传性癌症综合征的家族史（母亲患肺癌，舅舅40岁时患结肠癌）。该患者被诊断为直肠癌，接受了新辅助化疗及短程放疗，随后行机器人辅助低位前切除术并加做转流性回肠造口术。回肠造口关闭后，回肠造口切除标本的病理报告显示有一个1.1厘米的神经内分泌肿瘤，切缘阴性。
这种非同寻常的表现对患者来说可能非常偶然，在其他情况下，患者很可能在疾病进展或转移后才发现这个神经内分泌肿瘤。
