title: Advanced moderately differentiated neuroendocrine carcinoma of the rectum with favorable prognosis by postoperative chemoradiation.
abstract: Rectal neuroendocrine carcinoma is rare with poor prognosis. We report herein a case of advanced moderately differentiated neuroendocrine carcinoma of the rectum with relatively favorable prognosis treated by postoperative adjuvant chemoradiation therapy. A 58-year-old Japanese female was referred and colonofiberscopy revealed an easy-bleeding irregular tumor in the lower rectum, which was pathologically diagnosed as a neuroendocrine carcinoma. Surgical treatment consisted of abdominoperineal resection and lymph node dissection. The tumor invaded deeply into perirectal tissues, and 9 of 11 lymph node metastases were observed. Immunohistochemically, chromogranin A showed diffuse and strong staining, and the MIB-1 labeling index was 18.3 +/- 5.6, supporting the high proliferation of the tumor. Some nucleus of the tumor showed positive staining for p21/WAF1. A total dose of 46 Gy of radiotherapy was delivered with 800 mg of daily oral doxifluridine. At 5 years post-surgery, the patient demonstrated no clinical evidence of intrapelvic recurrence or distant metastases.
authors.affiliation: Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. h-iro@qg7.so-net.ne.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nojima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Seike
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kosugi
authors.forename: Takashi
authors.initials: T
authors.lastname: Shida
authors.forename: Keiji
authors.initials: K
authors.lastname: Koda
authors.forename: Kenji
authors.initials: K
authors.lastname: Oda
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kamata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishikura
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011182:Postoperative Care; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
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