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A case report of metastatic neuroendocrine carcinoma of the right adrenal gland successfully treated with chemotherapy and surgery

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Abstract

Poorly differentiated neuroendocrine carcinoma has a poor prognosis, especially when associated with distant metastasis. A 60-year-old man was admitted to a private hospital because of dyspnea at work in 2007. Computed tomography revealed lung infarction and a right adrenal tumor sized 12 cm in diameter that was tightly compressed against the inferior vena cava (IVC). Moreover, multiple lymph node metastases around the celiac axis and a solitary liver metastasis at the lateral segment were observed. Thus, we planned chemotherapy without surgery. We selected a combination therapy of irinotecan (CPT-11) and cisplatin (CDDP) (i.e., IP therapy): administration of CDDP [60 mg/m2 body surface area (BSA)] on day 1 plus CPT-11 (80 mg/m2) BSA on days 1 and 8. Thereafter, this protocol was repeated at 3-week intervals. After 15 months of this chemotherapy strategy, the whole lesions showed a partial response by RECIST. The primary tumor had shrunk to 4.2 cm in diameter. In November 2008, we planned surgery to perform resection of the whole lesions. Histological diagnosis of the specimen was a poorly differentiated neuroendocrine carcinoma based on the immunostaining features, i.e., synaptophysin- and chromogranin positive. There were no viable tumor cells at the dissected lymph nodes or at the liver tumor. After surgery, CPT-11 administration was continued. The patient has remained well for 9 months without recurrence.

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Abbreviations

BSA:

Body surface area

CDDP:

Cisplatin

CT:

Computed tomography

VP-16:

Etoposide

ENETS:

European Neuroendocrine Tumor Society

IFN:

Interferon

CPT-11:

Irinotecan

MRI:

Magnetic resonance image

NEC:

Neuroendocrine carcinoma

NET:

Neuroendocrine tumor

PD:

Poorly differentiated

RECIST:

Response evaluation criteria in solid tumor

WD:

Well-differentiated

WHO:

World Health Organization

References

  1. Solcia E, Kloppel G, Sobhin LH (2000) Histological typing of endocrine tumours. Springer, New York

    Google Scholar 

  2. Arnold R (2005) Endocrine tumours of the gastrointestinal tract. Introduction: definition, historical aspects, classification, staging, prognosis and therapeutic options. Best Pract Res Clin Gastroenterol 19:491–505

    Article  CAS  PubMed  Google Scholar 

  3. Rindl G, Kloppel G, Alhman H et al (2006) TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including grading system. Virchows Arch 449:395–401

    Article  Google Scholar 

  4. Bajetta E, Catena L, Procopio G et al (2005) Is the new WHO classification of neuroendocrine tumours useful for selecting an appropriate treatment? Ann Oncol 16:1374–1380

    Article  CAS  PubMed  Google Scholar 

  5. Rougier P, Mitry E (2000) Chemotherapy in the treatment of neuroendocrine malignant tumors. Digestion 62(suppl 1):73–78

    Article  CAS  PubMed  Google Scholar 

  6. Kaltsas GA, Mukherjee JJ, Isidori A et al (2002) Treatment of advanced neuroendocrine tumours using combination chemotherapy with lomustine and 5-fluorouracil. Clin Endocrinol (Oxf) 57:169–183

    Article  CAS  Google Scholar 

  7. Pectasides D, Pectasides M, Psyrri A et al (2006) Cisplatin-based chemotherapy for Merkel cell carcinoma of the skin. Cancer Invest 24:780–785

    Article  CAS  PubMed  Google Scholar 

  8. Ridolfi R, Amaducci L, Derni S et al (1991) Chemotherapy with 5-fluorouracil and streptozotocin in carcinoid tumors of gastrointestinal origin: experiences with 13 patients. J Chemother 3:328–331

    CAS  PubMed  Google Scholar 

  9. Rivera E, Ajani JA (1998) Doxorubicin, streptozotocin, and 5-fluorouracil chemotherapy for patients with metastatic islet-cell carcinoma. Am J Clin Oncol 21:36–38

    Article  CAS  PubMed  Google Scholar 

  10. Bajetta E, Ferrari L, Procopio G et al (2002) Efficacy of a chemotherapy combination for the treatment of metastatic neuroendocrine tumours. Ann Oncol 13:614–621

    Article  CAS  PubMed  Google Scholar 

  11. Artale S, Giannetta L, Cerea G et al (2005) Treatment of metastatic neuroendocrine carcinomas based on WHO classification. Anticancer Res 25:4463–4470

    PubMed  Google Scholar 

  12. Travis WD, Colby TV, Corrin B et al (1999) Histological typing of lung and pleural tumours. WHO international histological classification of tumours. Springer, Heidelberg

  13. Nomura S, Togawa A, Kaiho T et al (2009) A successful two-stage treatment with CDDP and CPT-11 for pancreatic neuroendocrine carcinoma with liver metastasis. Jpn J Cancer Chemother 36:1897–1900

    Google Scholar 

  14. Sandler A (2002) Irinotecan plus cisplatin in small-cell lung cancer. Oncology 16:39–43

    PubMed  Google Scholar 

  15. Noda K, Nishiwaki Y, Kawahara M et al (2002) Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. N Engl J Med 346:85–91

    Article  CAS  PubMed  Google Scholar 

  16. Lara PN Jr, Natale R, Crowley J et al (2009) Phase III trial of inotecan/cisplatin compared with etoposide/cisplatin in extensive-stage small-cell lung cancer: clinical and pharmacogenomic results from SWOGS0124. J Clin Oncol 27:2530–2535

    Article  CAS  PubMed  Google Scholar 

  17. Jiang L, Yang KH, Mi DH et al (2007) Safety of irinotecan/cisplatin versus etoposide/cisplatin for patients with extensive-stage small-cell lung cancer: a meta-analysis. Clin Lung Cancer 8:497–501

    Article  PubMed  Google Scholar 

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No author has any conflict of interest.

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Authors and Affiliations

  1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-Kawaramachi, Kamigyo-ku, Kyoto, 602-8566, Japan

    Toshiya Ochiai, Sosuke Komiyama, Hisashi Ikoma, Takeshi Kubota, Masayoshi Nakanishi, Daisuke Ichikawa, Shojiro Kikuchi, Hitoshi Fujiwara, Chohei Sakakura, Yukihito Kokuba, Teruhisa Sonoyama & Eigo Otsuji

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  1. Toshiya Ochiai
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  2. Sosuke Komiyama
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  3. Hisashi Ikoma
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  4. Takeshi Kubota
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  5. Masayoshi Nakanishi
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Correspondence to Toshiya Ochiai.

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Ochiai, T., Komiyama, S., Ikoma, H. et al. A case report of metastatic neuroendocrine carcinoma of the right adrenal gland successfully treated with chemotherapy and surgery. Int J Clin Oncol 15, 423–427 (2010). https://doi.org/10.1007/s10147-010-0051-z

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  • DOI: https://doi.org/10.1007/s10147-010-0051-z

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