tailieunhanh - Báo cáo khoa học: "Advanced moderately differentiated neuroendocrine carcinoma of the rectum with favorable prognosis by postoperative chemoradiation"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Advanced moderately differentiated neuroendocrine carcinoma of the rectum with favorable prognosis by postoperative chemoradiation | Nojima et al. World Journal of Surgical Oncology 2010 8 29 http content 8 1 29 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Ad vanced moderately differentiated neuroendocrine carcinoma of the rectum with favorable prognosis by postoperative chemoradiation Hiroyuki Nojima 1 Kazuhiro Seike 1 Chihiro Kosugi1 Takashi Shida1 Keiji Koda1 Kenji Oda1 Shigeyuki Kamata1 Hiroshi Ishikura2 and Masaru Miyazaki1 Abstract Rectal neuroendocrine carcinoma is rare with poor prognosis. We report herein a case of advanced moderately differentiated neuroendocrine carcinoma of the rectum with relatively favorable prognosis treated by postoperative adjuvant chemoradiation therapy. A 58-year-old Japanese female was referred and colonofiberscopy revealed an easy-bleeding irregular tumor in the lower rectum which was pathologically diagnosed as a neuroendocrine carcinoma. Surgical treatment consisted of abdominoperineal resection and lymph node dissection. The tumor invaded deeply into perirectal tissues and 9 of 11 lymph node metastases were observed. Immunohistochemically chromogranin A showed diffuse and strong staining and the MIB-1 labeling index was supporting the high proliferation of the tumor. Some nucleus of the tumor showed positive staining for p21 WAF1. A total dose of 46 Gy of radiotherapy was delivered with 800 mg of daily oral doxifluridine. At 5 years post-surgery the patient demonstrated no clinical evidence of intrapelvic recurrence or distant metastases. Background Neuroendocrine carcinomas of the colon and rectum are rare tumors with aggressive behavior and poorer prognosis compared with adenocarcinomas and the reported 3year survival rates are 13-15 1 . These carcinomas are subclassified into two pathological types small cell carcinomas and moderately differentiated neuroendocrine carcinomas. Small cell carcinoma of the colon and rectum is virtually indistinguishable from small cell lung cancer morphologically and .