Large cell neuroendocrine tumor of the gastrointestinal tract with concurrent tubular adenomas
Gazzetta Medica Italiana Archivio per le Scienze Mediche
Large cell neuroendocrine carcinomas (LCNECs) are rare, aggressive tumors, often diagnosed in advanced stages due to early metastasis. The concurrent presentation of both LCNEC and tubular adenomas has been reported in only a few cases. We present a case of 56-year-old male who presented with abdominal discomfort and dyspepsia for several months. A CT scan done on admission revealed a 3.7x1.7 cm colonic mass at the splenic flexure with multiple liver and vertebral lesions. A subsequent colonoscopy showed a fungating and partially obstructing mass in the transverse colon with multiple tubular adenomas. The immunohistochemical profile was positive for chromogranin, synaptophysin and 60% Ki-67 activity consistent with LCNEC diagnosis. Patient received adjuvant chemotherapy with Carboplatin and Etoposide, achieving remission for 8 months. However, at a follow-up appointment, renal and hepatic function worsened, and a repeat CT showed disease progression. Patient decided to forego treatment and enrolled in hospice care. The coexistence of LCNEC and tubular adenoma allowed for prompt initiation of treatment to treat this aggressive tumor, also leading to the postulation that the two lesions might share a common origin.
Gill I, Shams C, Quiroz E, Krishnan SM, Gaikazian S. Large cell neuroendocrine tumor of the gastrointestinal tract with concurrent tubular adenomas. Gazz Med Ital Arch Sci Med. 2021 Sept;180(9):498-502. doi: 10.23736/S0393-3660.20.04399-5.