title: Metastatic rectal neuroendocrine tumor presenting as an inguinal mass: A case report and review of literature.
abstract: BACKGROUND
  Neuroendocrine tumors (NET) are a heterogeneous group of rare carcinomas that most often manifest along the gastrointestinal tract. Some of these tumors have the ability to secrete vasoactive peptides and hormones.
  
  
  METHODS
  The present report describes the case of a previously healthy 52-year old man who presented with a painful right inguinal mass. Upon surgical exploration, a lymph node metastasis of a high-grade NET was found. Further investigations revealed a rectal NET with pulmonary, pelvic and penile metastases. The patient was treated with 6 cycles of carboplatin and etoposide. Although initial follow-up imaging after 3 cycles of chemotherapy revealed stable disease, there was progression of the metastases after completion of systemic treatment. Second and third-line chemotherapy regimens were instituted along with pelvic and whole-brain radiation therapy extending the patient's survival to 18 months after the initial diagnosis.
  
  
  CONCLUSIONS
  This case highlights the aggressive nature high-grade NETs as described in the current literature. Treatment modalities of colorectal NETs include local excision for non-metastatic disease and systemic palliative chemotherapy for advanced disease. However, there are no controlled trials in favor of palliative chemotherapy.
  
  
  CONCLUSIONS
  Rectal NETs are rare tumors which often have an atypical presentation or present in advanced stages. Currently, surgical options exist for local disease while treatment modalities for more advanced disease is still under investigation.
authors.affiliation: Department of Surgery, CHUM, 3840, Rue Saint-Urbain, Montreal, Québec H2 W 1T8, Canada; Department of Surgery, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada. Electronic address: adam.di.palma@umontreal.ca.
authors.forename: Adam
authors.initials: A
authors.lastname: Di Palma
authors.affiliation: Department of Surgery, CHUM, 3840, Rue Saint-Urbain, Montreal, Québec H2 W 1T8, Canada; Department of Surgery, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada. Electronic address: sebajang@hotmail.com.
authors.forename: Herawaty
authors.initials: H
authors.lastname: Sebajang
authors.affiliation: Department of Surgery, CHUM, 3840, Rue Saint-Urbain, Montreal, Québec H2 W 1T8, Canada; Department of Surgery, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada. Electronic address: frank.schwenter.chum@ssss.gouv.qc.ca.
authors.forename: Frank
authors.initials: F
authors.lastname: Schwenter
keywords: Chemotherapy; Gastrointestinal neuroendocrine tumor; Metastatic neuroendocrine tumor; NET; Rectal neuroendocrine tumor; Surgical oncology