Tanaka Yuya, Takagi Masayuki, Nakayama Toshihiro, Kawada Shuhei, Matsushita Reika, Matsushita Tsunehisa, Ozaki Takahiro, Takagi Shimpei, Komai Sota, Sumi Yasuhiro
Department of Surgery, Shizuoka Medical Center NHO, 762-1, Nagasawa, Shimizu, Sunto, Shizuoka, 411-8611, Japan.
Department of Pathology, Shizuoka Medical Center NHO, 762-1, Nagasawa, Shimizu, Sunto, Shizuoka, 411-8611, Japan.
Clin J Gastroenterol. 2025 Apr;18(2):314-323. doi: 10.1007/s12328-024-02089-5. Epub 2025 Jan 12.
Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) of the colon is rare with a poor prognosis. Since the first description of a mixed neoplasm 100 years ago, the nomenclature has evolved, most recently with the 2022 World Health Organization (WHO) classification system. We describe our experience of a case of locoregionally advanced MiNEN of the descending colon treated with curative laparoscopic resection and adjuvant chemotherapy. The patient is a 72 year old woman who presented with haematochezia. Initial clinical diagnosis was poorly differentiated adenocarcinoma of the descending colon, cT2N0M0, cStage I. Laparoscopic partial colectomy of the descending colon with D3 lymph node dissection and intracorporeal overlap anastomosis was performed. The pathological diagnosis however, returned mixed adenocarcinoma-neuroendocrine carcinoma (MANEC) of the descending colon, pT4aN1bM0, pStage IIIB, a subgroup of MiNEN: 70% was neuroendocrine carcinoma (NEC), whilst poorly differentiated mucinous carcinoma constituted 30% of the tumour. She completed 4 courses of irinotecan plus cisplatin (IP) adjuvant chemotherapy and is currently recurrence-free at postoperative year 2. The clinical course of MiNEN depends on the biology of the two components, both of which must be pathologically characterised. Even quantitatively discrete components should be carefully subtyped as their prognostic relevance is undetermined.
结肠混合性神经内分泌-非神经内分泌肿瘤（MiNEN）罕见，预后较差。自100年前首次描述混合性肿瘤以来，其命名法不断演变，最近采用了2022年世界卫生组织（WHO）分类系统。我们描述了一例降结肠局部晚期MiNEN患者接受根治性腹腔镜切除和辅助化疗的经验。患者为一名72岁女性，表现为便血。初始临床诊断为降结肠低分化腺癌，cT2N0M0，c期I。行降结肠腹腔镜部分切除术，D3淋巴结清扫及体内吻合。然而，病理诊断为降结肠混合性腺癌-神经内分泌癌（MANEC），pT4aN1bM0，p期IIIB，MiNEN的一个亚组：70%为神经内分泌癌（NEC），而低分化黏液癌占肿瘤的30%。她完成了4个周期的伊立替康加顺铂（IP）辅助化疗，目前术后2年无复发。MiNEN的临床病程取决于两个成分的生物学特性，两者都必须进行病理特征分析。即使是数量上离散的成分也应仔细分型，因为它们的预后相关性尚未确定。
