title: Advanced small-cell colon carcinoma: a case report.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
authors.affiliation: Division of Surgery, Heiwa Hospital, 29-1 Higashiterao Nakadai Tsurumi-ku, Yokohana city, Kanagawa, 230-0017, Japan. computerbody@hotmail.com.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Iwase
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Masuda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahashi
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki