title: [A case of neuroendocrine carcinoma of the anal canal with multiple bone metastases successfully treated with combined modality therapy].
abstract: Neuroendocrine carcinoma (NEC) of the anal canal is a comparatively rare tumor with a poor prognosis. We report herein a case of NEC of the anal canal with multiple bone metastases that was successfully treated with combined therapy. A 63-year-old man was referred to our hospital with the chief complaint of anal and back pain. A tumor was found in the anal canal, and pathologic examination revealed it to be NEC( Ki-67 expression>50%); fluorodeoxyglucose( FDG) positron emission tomography (PET)-computed tomography (CT) showed multiple bone metastases. Initially, a l-leucovorin/5- fluorouraci(l 5-FU)/oxaliplatin( L-OHP)(: mFOLFOX6)/bevacizumab( Bmab) regimen and octreotide were administered to treat the unresectable and advanced NEC. Strontium-89 and zoledronate were used to treat pain related to the bone metastases. After 3 months, the tumor and bone metastases became difficult to identify. The patient experienced grade 2 neurotoxicity after 5 months, and thus, we stopped L-OHP administration. After 10 months, we reintroduced L-OHP because of additional progression of the bone metastases.
authors.affiliation: Dept. of Surgical Oncology, Graduate School, Tokyo Medical and Dental University.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Baba
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Noriko
authors.initials: N
authors.lastname: Iwata
authors.forename: Hidenori
authors.initials: H
authors.lastname: Takahashi
authors.forename: Taiki
authors.initials: T
authors.lastname: Masuda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okazaki
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Matsuyama
authors.forename: Megumi
authors.initials: M
authors.lastname: Ishiguro
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Iida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uetake
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugihara
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D018278:Carcinoma, Neuroendocrine / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed