Rare finding of a large cell poorly differentiated neuroendocrine tumor in the colon
Keywords:Large cell neuroendocrine tumor, Neuroendocrine tumor, Poorly differentiated neuroendocrine tumor, Large bowel mass
A 43 year old female presented to the emergency department for nausea, vomiting and abdominal pain secondary to a bowel obstruction subsequently revealed to be a poorly differentiated large cell neuroendocrine tumor of the colon. After a CT scan showed a mass in the ascending colon with possible metastasis to the right lobe of the liver, an exploratory laparotomy was performed. A hemicolectomy was performed with biopsy of the liver mass. Pathology was consistent with large cell neuroendocrine tumor in all specimens including the liver biopsy, ascending colon, and transverse colon. Although large cell neuroendocrine tumors of the colon are a rare malignancy, they are an important consideration in the workup of multiple colonic masses with metastases, especially in patients presenting with bowel obstruction. The literature on poorly differentiated large cell neuroendocrine cancer and treatment is reviewed. Poorly differentiated large cell neuroendocrine tumor is a rare pathology but should be included in the differential diagnosis in patients presenting with a colon mass and bowel obstruction.
Kloppel, Gunter. The Gastroenteropancreatic Neuroendocrine Cell System and Its Tumors: The WHO Classification. Annals New York Academy Sci. 2004;1014:13-27.
Smith, James D. A Retrospective Review of 126 High-Grade Neuroendocrine Carcinomas of the Colon and Rectum. Annals Surg Oncology. 2014;21(9):2956-62.
Selvi SK, Srinivas BH, Badhe BA, Dharanipragada K. Synchronous Neuroendocrine Carcinoma of Colon Presenting as Subacute Intestinal Obstruction: a rare case report. J Gastrointestinal Cancer. 2017;4:525-7.
Bernick PE. Neuroendocrine Carcinomas of the Colon and Rectum. Diseases Colon Rectum, 2004;47(2):163-9.
Travis, William D, Linnoila RI, Tsokos, Maria G, Hitchock, et al. Neuroendocrine Tumors of the Lung with Proposed Criteria for Large-Cell Neuroendocrine Carcinoma. American J Surg Pathology. 1991;15:529-53.
Solcia E, Kloppel G, Sobin LH. Histological typing of endocrine tumors. 2nd ed. Heidelberg (Germany): Springer; 2000:61-68.
Pascarella, Michael R, Closkey M, David, Walcott J, Jenia, et al. Large Cell Neuroendocrine Carcinoma of the Colon: a rare and aggressive tumor. J Gastrointestinal Oncology. 2011;4:250-3.
Vilallonga R. Neuroendocrine Carcinomas of the Colon and Rectum. A Unit’s Experience Over Six Years. Revista Espanola de Enfermedades Digestivas. 2008;100:11-16.
Nojima, Hiroyuki. Advanced Moderately Differentiated Neuroendocrine Carcinoma of the Rectum with Favorable Prognosis by Postoperative Chemoradiation. World J Surg Oncology. 2010;8(1):29.
Soin, Sarthak. Large Cell Neuroendocrine Carcinoma and Adenocarcinoma of Gallbladder with Concomitant Hepatitis C Infection. BMJ Case Reports 2018.
Fields, Adam C. Survival in Patients with High-Grade Colorectal Neuroendocrine Carcinomas: The Role of Surgery and Chemotherapy. Annals Surg Oncol. 2019;26(4):1127-33.
Mitry E. Treatment of Poorly Differentiated Neuroendocrine Tumors with Etoposide and Cisplatin. Br J Cancer. 1999;81(8):1351-5.
Kim, Gu H. A Case of Large Cell Neuroendocrine Carcinoma of the Colon. Korean J Gastroenterol. 2009;54(1):46.
Starzynska, Teresa. Colorectal Neuroendocrine Neoplasms - Management Guidelines (Recommend- ed by the Polish Network of Neuroendocrine Tumors). Endokrynologia Polska. 2014;64(6):494-504.
Yamaguchi, Tomohiro. Multicenter Retrospective Analysis of Systemic Chemotherapy for Advanced Neuroendocrine Carcinoma of the Digestive System. Cancer Sci. 2014;105(9):1176-81.
Yoshida, Tomoaki. Colorectal Neuroendocrine Carcinoma: a case report and review of the literature. World J Clin Cases. 2019;7(14):1865-75.