Advanced Small-Cell Colon Carcinoma
Introduction Small-cell colon carcinoma is a very rare disease among colon neoplasms; it is difficult to achieve long-term survival due to its aggressive tumor behavior. Here we report the long-term survival of a patient with advanced small-cell colon carcinoma achieved by a combination of surgery and continuous chemotherapy.
Case presentation A 67-year-old Japanese man underwent abdominal computed tomography in our institution for follow up after gastrectomy, and abnormal thickness of the sigmoid colon wall was revealed. An endoscopy demonstrated a 20mm Bormann 2 lesion with central ulceration located 20cm from the anal verge. A sigmoidectomy was performed. Histologically, the tumor deeply invaded the tissue and extended beyond the serosa, and was diagnosed as small-cell carcinoma. Cisplatin plus irinotecan was administered for adjuvant chemotherapy. Nine months after surgery, a follow-up computed tomography showed an enlarged lymph node behind the inferior vena cava and a 15×8mm nodule located at the ventral side of the cecum. Under consideration of progressive disease, cisplatin plus irinotecan therapy was performed again using the same regimen. After nine cycles of cisplatin plus irinotecan therapy, a follow-up gastric endoscopy demonstrated external tumor invasion to the duodenum wall. Carboplatin plus etoposide therapy was selected as a third-line regimen. After six cycles of carboplatin plus etoposide therapy, the recurrence sites were maintained in a stable condition, and the survival time reached approximately 30 months after the initial surgery.
Conclusions We report the long-term survival of a patient with advanced small-cell colon carcinoma. In the future, the accumulation and analysis of rare cases that obtain a better survival time will contribute to clarifying neuroendocrine carcinoma biology, and help to improve the prognosis.
According to the classification of neuroendocrine tumors by the World Health Organization (WHO), small-cell colon carcinoma is categorized as a neuroendocrine carcinoma (NEC), which has high malignancy. A NEC can occur anywhere in the gastrointestinal tract but it is rarely found in the colon: NEC has an incidence rate of only 0.6% of total colon malignancies. Due to aggressive tumor behavior, distant metastases in internal organs or regional lymph nodes are often found at the same time as detection of a tumor. In addition to these facts, high recurrence rates contribute to poor survival, with a median survival of 10.5 months. In patients with a metastatic lesion at the time of the surgery, the median survival time is only four months.
Here we report the long-term survival of a patient with advanced small-cell colon cancer who received continuous chemotherapy.
Abstract and Introduction
Abstract
Introduction Small-cell colon carcinoma is a very rare disease among colon neoplasms; it is difficult to achieve long-term survival due to its aggressive tumor behavior. Here we report the long-term survival of a patient with advanced small-cell colon carcinoma achieved by a combination of surgery and continuous chemotherapy.
Case presentation A 67-year-old Japanese man underwent abdominal computed tomography in our institution for follow up after gastrectomy, and abnormal thickness of the sigmoid colon wall was revealed. An endoscopy demonstrated a 20mm Bormann 2 lesion with central ulceration located 20cm from the anal verge. A sigmoidectomy was performed. Histologically, the tumor deeply invaded the tissue and extended beyond the serosa, and was diagnosed as small-cell carcinoma. Cisplatin plus irinotecan was administered for adjuvant chemotherapy. Nine months after surgery, a follow-up computed tomography showed an enlarged lymph node behind the inferior vena cava and a 15×8mm nodule located at the ventral side of the cecum. Under consideration of progressive disease, cisplatin plus irinotecan therapy was performed again using the same regimen. After nine cycles of cisplatin plus irinotecan therapy, a follow-up gastric endoscopy demonstrated external tumor invasion to the duodenum wall. Carboplatin plus etoposide therapy was selected as a third-line regimen. After six cycles of carboplatin plus etoposide therapy, the recurrence sites were maintained in a stable condition, and the survival time reached approximately 30 months after the initial surgery.
Conclusions We report the long-term survival of a patient with advanced small-cell colon carcinoma. In the future, the accumulation and analysis of rare cases that obtain a better survival time will contribute to clarifying neuroendocrine carcinoma biology, and help to improve the prognosis.
Introduction
According to the classification of neuroendocrine tumors by the World Health Organization (WHO), small-cell colon carcinoma is categorized as a neuroendocrine carcinoma (NEC), which has high malignancy. A NEC can occur anywhere in the gastrointestinal tract but it is rarely found in the colon: NEC has an incidence rate of only 0.6% of total colon malignancies. Due to aggressive tumor behavior, distant metastases in internal organs or regional lymph nodes are often found at the same time as detection of a tumor. In addition to these facts, high recurrence rates contribute to poor survival, with a median survival of 10.5 months. In patients with a metastatic lesion at the time of the surgery, the median survival time is only four months.
Here we report the long-term survival of a patient with advanced small-cell colon cancer who received continuous chemotherapy.
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