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Mixed neuroendocrine–non-neuroendocrine neoplasm with squamous cell carcinoma covered by tubulovillous adenoma in the rectum

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Abstract

A variety of histologies is often mixed in neuroendocrine carcinoma (NEC) called mixed neuroendocrine–non-neuroendocrine neoplasm (MiNEN). However, tumors consisting of both large-cell NEC and squamous cell carcinoma (SCC) are rare. NEC of the large intestine is aggressive; however, an ideal treatment strategy has not been established. In this study, we have reported a case of rectal MiNEN containing large-cell NEC and SCC that was covered by tubulovillous adenoma. A 73-year-old man was referred to our hospital for the treatment of an upper rectal tumor. The results of preoperative biopsy indicated tubulovillous adenoma, whereas computed tomography revealed multiple liver tumors and swollen lymph nodes around the rectum. Laparotomy was performed because of severe dyschezia caused by rectal stenosis. Hartmann’s operation was performed because of peritoneal metastases. Histopathological examination of the rectal tumor revealed MiNEN containing large-cell NEC, SCC, well-differentiated adenocarcinoma, and tubulovillous adenoma covering the surface of the tumor. The patient died 73 days after surgery due to liver metastases. It is important to consider NEC in the differential diagnosis and tissue sampling should be performed to ensure appropriate management when pathological findings and clinical diagnosis do not match. More research is required to determine the ideal treatment for these rare and aggressive tumors.

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Acknowledgements

The authors would like to thank MARUZEN-YUSHODO Co., Ltd. (https://kw.maruzen.co.jp/kousei-honyaku/) for the English language editing.

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No financial support was received for the work described in this manuscript.

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Authors and Affiliations

  1. Department of Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan

    Harunobu Sato & Ichiro Uyama

  2. Department of Surgery, Kaisei Hospital, Sakaide, Japan

    Miho Shiota

  3. Department of Pathology, School of Medicine, Fujita Health University, Toyoake, Japan

    Makoto Urano & Tetsuya Tsukamoto

  4. Department of Surgery, Rokuwa Hospital, Inazawa, Japan

    Katsuyuki Honda

  5. Department of Surgery, Hatakawa Clinic, Gamagori, Japan

    Kunihiro Toyama

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  1. Harunobu Sato
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  2. Miho Shiota
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  3. Makoto Urano
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  4. Tetsuya Tsukamoto
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  5. Katsuyuki Honda
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  6. Kunihiro Toyama
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  7. Ichiro Uyama
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Correspondence to Harunobu Sato.

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Harunobu Sato, Miho Shiota, Makoto Urano, Tetsuya Tsukamoto, Katsuyuki Honda, Kunihiro Toyama and Ichiro Uyama declare that they have no conflict of interest.

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Sato, H., Shiota, M., Urano, M. et al. Mixed neuroendocrine–non-neuroendocrine neoplasm with squamous cell carcinoma covered by tubulovillous adenoma in the rectum. Clin J Gastroenterol 14, 1136–1141 (2021). https://doi.org/10.1007/s12328-021-01420-8

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  • DOI: https://doi.org/10.1007/s12328-021-01420-8

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