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Long-term complete response in metastatic poorly-differentiated neuroendocrine rectal carcinoma with a multimodal approach: A case report

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World Journal of Clinical Oncology 2021年第6期12卷 500-506页

作者： Silvia Della Torre Germana de Nucci Pietro Maria Lombardi samuele grandi Gianpiero Manes Roberto Bollina Oncology Unit ASST RhodenseRho 20017Italy Department of Gastroenterology Garbagnate Milanese HospitalASST RhodenseGarbagnate Milanese 20024Italy Minimally Invasive Surgery Division Niguarda HospitalMilan 20110Italy Robotic and Emergency Surgery General Surgery DivisionManzoni HospitalLecco 23900Italy Gastroenterology Unit ASST Rhodense-Garbagnate MilaneseGarbagnate Milanese 20054Italy

BACKGROUND Neuroendocrine gastrointestinal tumors(NETs)are rare and have different natural *** is the gold standard treatment for local disease while radiotherapy has been demonstrated to be *** differentiated neuroendocrine carcinomas(NECs)represent only 5%-10%of digestive *** to aggressive growth and rapid metastatic diffusion,early diagnosis and a multidisciplinary approach are *** role of surgery and radiotherapy in this setting is still debated,and chemotherapy remains the treatment of *** SUMMARY A 42-year-old male with an ulcerated bleeding rectal lesion was diagnosed with a NEC G3(Ki67 index>90%)on May 2015 and initially treated with 3 cycles of first-line chemotherapy,but showed early local progressive disease at 3 mo and underwent sphincter-sparing open anterior low rectal *** September 2015,the first post-surgery total-body computed tomography(CT)scan showed an early pelvic disease ***,systemic chemotherapy with FOLFIRI was started and the patient obtained only a partial *** was followed by pelvic radiotherapy(50 Gy).On April 2016,a CT scan and 18F-fluorodeoxy-glucose positron emission tomography imaging showed a complete response(CR)of the pelvic lesion,but pathological abdominal inter-aortocaval lymph nodes were *** to disease progression of abdominal malignant nodes,the patient received radiotherapy at 45 Gy,and finally obtained a *** of January 2021,the patient has no symptoms of relapse and no late toxicity after chemotherapy or *** This case demonstrates how a multimodal approach can be successful in obtaining long-term CR in metastatic sites in patients with high grade digestive NECs.

关键词： Neuroendocrine tumor Multimodal therapy Rectal carcinoma Surgery Radiotherapy Case report

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