集学的治療により再発後２０カ月無増悪の直腸内分泌細胞癌の１例

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  • A GIANT ENDOCRINE CELL CANCER OF THE RECTUM THAT REMAINED PROGRESSION FREE FOR 20 MONTHS WITH MULTIDISCIPLINARY TREATMENT

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We report a recurrent case of giant endocrine cell eancer (ECC) of the rectum that remained progression free for 20 months with multidisciplinary treatment. A 48-year-old man visited our hospital because of incontinence and anal pain. Colonoscopy showed a giant submucosal tumor with central ulceration in the rectum. CT and MRI revealed a heterogeneous mass in the pelvic space, which measured 12cm and invaded the pelvic wall. Angiography showed that it was supplied from the superior mesenteric and internal iliac arteries. The tumor was diagnosed from a biopsy as ECC and the patient underwent radical abdominoperineal resection. The resected specimen showed hemorrhagic necrosis in the center of the tumor invading the piriform muscle with lymph node metastas. Immunohistochemical staining detected NSE and CD56. Four months after the surgery, local recurrence and liver metastasis were seen, and radiation and transcatheter arterial chemoembolization were performed. Systemic chemotherapy with CDDP, CPT-11, and L-OHP followed. The tumor soon diminished, and the patient has remained progression free for 20 months.

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