Cecal Adenoendocrine Cell Carcinoma Presented with Right Inguinal Lymph Node Metastasis Yields Complete Response to mFOLFOX6 and Bevacizumab:A Case Report

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  • Mukai Toshiki
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Fukunaga Yosuke
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Ikeda Atsushi
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Neki Kai
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Nagasue Yasutomo
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Yamakawa Keiko
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Oikawa Yoshinori
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Akiyoshi Takashi
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Konishi Tsuyoshi
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Fujimoto Yoshiya
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Nagayama Satoshi
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Ueno Masashi
    Gastroenterological Center, Department of Gastroenterological Surgery, Japanese Foundation For Cancer Research
  • Mizunuma Nobuyuki
    Gastroenterological Center, Department of Gastroenterological Medicine, Japanese Foundation For Cancer Research

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  • 術前mFOLFOX6+bevacizumabが奏効しpCRを得た盲腸腺内分泌細胞癌の1切除例

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Abstract

A 58-year-old man was referred to our hospital because of right lower abdominal pain. Colonoscopy and PET-CT revealed an advanced cancer of the cecum with right inguinal lymph node metastasis. Biopsy showed poorly differentiated adenocarcinoma with neuroendocrine differentiation. Immunostaining for Ki-67, CD56 and Chromogranin A were positive. Systemic chemotherapy using six cycles of mFOLFOX6 combined with bevacizumab resulted in reduction of the inguinal lymphadenopathy. Laparoscopic ileocecal resection with right inguinal lymph node dissection was then performed. Pathological complete response (pCR) was confirmed by histopathological examination. This patient is alive without recurrence 18 months after surgery.<BR>Neuroendocrine cell carcinoma of the colon is rare and its prognosis is poor. Inguinal lymph node metastasis from the colon is another poor prognostic factor. This patient had a remarkably good response to a general therapeutic chemotherapy regimen for colorectal carcinoma, followed by sequential radical surgery. In conclusion, multitherapeutic modalities should be considered for patients with neuroendocrine cell carcinoma in need of a drastic effect and cure.

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