0045 Colon
NEUROENDOCRINE CARCINOMA OF THE RECUM
N. Issa, N. Nasralla, D. Frenkel*, I. Shnirer**, A. Rosen.
Department of Surgery “A” and Gastroenterology*and Oncology**
and Nuclear Medicine***, Edith Wolfson Medical Center, Holon
and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Neuroendocrine cells are widely distributed in the gastrointestinal tract
including the large bowel, but the neuroendecrine tumors arising in the colon
and rectum are rare.
(comprising 0.6-3.9% in different series)
There are two main groups of neuroendocrine tumors; the carcinoid tumorswhich are considered a benign or a very high grade neuroendocrine carcinoma.
And the low grade neuroendocrine carcinoma. Both groups are slightly more
common in women, with average presentation at fifth decade.
The neuroendocrine carcinomas are categorized as small cell carcinoma and
large cell neuroendocrine carcinoma. This tumors represent heterogeneous
group by means of immunohistochemistery for neuroendocrine markers.
Most neuroendocrine carcinomas present late, and about 80% are Duke C or D
at the time of diagnosis.
Few cases present carcinoid syndrome manifestation.
The diagnosis of the neuroendocrine carcinomas resemble that of the
colorectal adenocarcinoma. About 60% of the tumors can be diagnosed by
tissue biopsy.
The somatostatin receptor imaging is effective mainly in the carcinoid tumors.
Small cell neuroendocrine carcinomas are very aggressive and have structural
and functional similarities with small cell carcinoma of the lung.
Survival is poor, (mean 7-10 months).
There is no optimal threatment for neuroendocrine carcinoma of the large
bowel, chemotherapy, mainly cisplatin, combined with surgery (in dibate) give
sometimes transient regression of the tumor.
We present a 65 years old male, with small cell neuroendocrine carcinoma of
the rectum.
The diagnostic and the therapeutic options are discussed, and littreture revue is
sommerised.