Case report: Coexistence of sigmoid tumor with unusual pathological features and multiple colorectal neuroendocrine tumors with lymph node metastases

Shu Pang; Jiugang Song; Kun Zhang; Jia Wang; Haiying Zhao; Yongjun Wang; Peng Li; Ye Zong; Yongdong Wu

doi:10.3389/fonc.2023.1073234

Case report: Coexistence of sigmoid tumor with unusual pathological features and multiple colorectal neuroendocrine tumors with lymph node metastases

Front Oncol. 2023 Mar 13:13:1073234. doi: 10.3389/fonc.2023.1073234. eCollection 2023.

Authors

Shu Pang¹, Jiugang Song², Kun Zhang³, Jia Wang⁴, Haiying Zhao², Yongjun Wang², Peng Li², Ye Zong², Yongdong Wu²

Affiliations

¹ Department of General Practice, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
² Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
³ Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
⁴ Department of Ultrasonography, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Abstract

The coexistence of adenocarcinoma and neuroendocrine neoplasm (NEN) in the same tumor is rare. What is rarer is that the neuroendocrine component is a well-differentiated neuroendocrine tumor (NET) Grade (G) 1. Most colorectal NETs are single, but multiple neuroendocrine tumors (M-NETs) are rare. Well-differentiated NETs rarely metastasize. Here, we present a unique case of a synchronous sigmoid tumor and multiple colorectal NETs with lymph node metastases. The sigmoid tumor consisted of adenocarcinoma and NET G1. The metastatic component was NET G1. A 64-year-old man underwent a colonoscopy for persistent changes in bowel habits and positive fecal occult blood for 1 year. An ulcerative lesion, which was diagnosed as colon cancer, was seen in the sigmoid colon. In addition, scattered lesions could be seen in the colon and rectum. Surgical resection was performed. Pathological findings suggested that the ulcerative lesion was composed of 80% adenocarcinoma and 20% neuroendocrine component (NET G1), while the remaining lesions were consistent with NET G1. At the same time, 11 lymph nodes around the resected intestinal segment were invaded by NET G1. The prognosis of the patient was good. After 13 months of follow-up, no recurrence and no metastasis were found. We hope to provide a reference and improve our understanding of the clinicopathological features and biological behavior of these unique tumors. We also aim to emphasize the importance of radical surgery and individualized treatment.

Keywords: adenocarcinoma; case report; lymph nodes metastases; multiple colorectal neuroendocrine tumors; neuroendocrine; sigmoid neoplasm.

Publication types

Case Reports

Grants and funding

This work was supported by the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority No. XXT08. The funder had no role in study design, data collection, analysis and interpretation, the decision to submit the article for publication, or the preparation of the manuscript.