Two Cases of Small Cell Carcinoma of the Rectum with Favorable Course by Multidisciplinary Treatment

Hiroshige Saito, Manabu Shiozawa, Nobuhiro Sugano, Kazuhito Tsuchida, Makoto Akaike, Yukio Sugimasa and Shoji Takemiya

Department of Gastrointestinal Surgery, Kanagawa Cancer Center

Case 1: A 50-year-old woman referred under a diagnosis of rectal carcinoma was found on further examination to have a type 2 tumor in the upper part of the rectum and swollen paraaortic lymph nodes. A low anterior resection was carried out which was not curative due to the paraaortic metastatic lymph nodes. Swelling of the paraaortic lymph nodes disappeared after a course of postoperative chemotherapy, but at 57 months after operation, abdominal CT revealed recurrence of the swelling in the paraaortic lymph nodes. They were eliminated after 4 cycles of chemotherapy and to date she is disease-free at 105 months after surgery. Case 2: A 29-year-old man was admitted for anal bleeding and an elevated lesion like a submucosal tumor was detected in the lower part of the rectum. Colonoscopic biopsy demonstrated a small cell carcinoma and 3 courses of chemotherapy and radiotherapy were performed. The tumor markedly decreased and an abdominoperineal resection was performed. Histopathological examination of the resected specimen showed no residual cancer cells and the patient remains well with no sign of recurrence at present, 19 months after chemotherapy. Although small cell carcinoma of the rectum has a very poor prognosis, combined therapy may be extremely effective, thus we recommend aggressive treatment for this disease.

Key words
small cell carcinoma, rectum, multidisciplinary treatment

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Hiroshige Saito　Department of Gastrointestinal Surgery, Kanagawa Cancer Center
1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815 JAPAN

Accepted
January 25, 2006

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