A Case of Juvenile Endocrine Cell Carcinoma of the Transverse Colon

Satoshi Yodonawa, Isao Ogawa, Yukinobu Goto, Hiromichi Ito, Miyuki Kitahara and Tatsuo Asagoe

Department of Surgery, Ibaraki Seinan Medical Center Hospital

A 34-year-old man referred for melena and abdominal mass was found, on admission, by abdominal CT and MRI to have a huge left upper abdominal mass. Closer examination showed a suspected mesenchymal tumor arising from the transverse mesocolon, involving the transverse colon and pancreas, necessitating en bloc resection of the tumor by left hemicolectomy, distal pancreatectomy, and splenectomy. The resected 17×11×8 cm, 1,500 g tumor consisted microscopically of atypical polygonal cells proliferating in a solid nest with abundant eosinophilic cytoplasm. Immunohistochemically, tumor cells were positive for synaptophysin, chromogranin A, and neuronal-specific enolase (NSE), and the tumor was diagnosed as endocrine cell carcinoma. The patient underwent adjuvant chemotherapy with CDDP and CPT-11, but died due to local recurrence, liver metastasis, and peritonitis carcinomatosa 7 months after surgery. The prognosis of colorectal endocrine cell carcinoma is dismal, requiring effective intensive treatment, including neoadjuvant chemotherapy and radiation.

Key words
endocrine cell carcinoma, transverse colon

Reprint requests
Satoshi Yodonawa Department of Surgery, Ibaraki Seinan Medical Center Hospital
2190 Sakai-machi, Sashima-gun, 306-0433 JAPAN

Accepted
September 28, 2005

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