A case of a tiny neuroendocrine carcinoma in a large flat-elevated rectal tumor causing multiple liver metastases.
Daisuke OhkiYosuke TsujiMariko TanakaTetsuo UshikuMitsuhiro FujishiroPublished in: Clinical journal of gastroenterology (2022)
Neuroendocrine tumors are rare malignancies comprising neuroendocrine cells widely distributed in the human body. They occur in various organs of the body, most commonly in the gastrointestinal tract and pancreas in the Japanese population. Mixed neuroendocrine-non-neuroendocrine neoplasm is included in the 2019 WHO classification and defined as having more than 30% of both neuroendocrine and non-neuroendocrine tumor components. However, the number of reports on mixed neuroendocrine and non-neuroendocrine tumors is particularly small. Herein, we encountered a rare case of a tiny neuroendocrine carcinoma in a large flat-elevated rectal tumor resulting in rapid multiple liver metastases. This case was referred to our institution for endoscopic submucosal dissection. Histopathological analysis showed that tubular adenocarcinoma and adenoma were the predominant lesions. Moreover, the neuroendocrine carcinoma component was less than 3% of the total tumor, measuring approximately 5 mm. However, the neuroendocrine carcinoma component was found to be the most advanced part of the infiltrate (T1b at least; SM3.8 mm). Repeat computed tomography 1 week after endoscopic submucosal dissection for evaluating intraoperative perforation revealed liver metastasis, and chemotherapy is currently underway.
Keyphrases
- liver metastases
- neuroendocrine tumors
- computed tomography
- endoscopic submucosal dissection
- rare case
- squamous cell carcinoma
- clinical trial
- machine learning
- emergency department
- randomized controlled trial
- induced apoptosis
- patients undergoing
- deep learning
- cell death
- endoplasmic reticulum stress
- electronic health record
- cell proliferation
- pet ct
- quantum dots
- contrast enhanced
- data analysis