Neuroendocrine Carcinoma of the Colon: Report of 3 Cases

Yasuhiro Kouchi, Mitsutaka Jimbou, Masatoshi Shigeta, Tomohiro Inokuchi, Yuji Fujita, Makoto Miyahara, Hidefumi Kubo, Hiroyasu Hasegawa and Hiroshi Miyashita

Department of Surgery, Social Insurance Tokuyama Central Hospital

Neuroendocrine carcinomas were diagnosed in 3 of 1,021 patients who had colon cancers removed from October 1997 to September 2002 for an incidence of 0.29%. Patients were 2 men and 1 woman, 59 to 70 years of age (median, 65.3 years). Treatment involved: 2 right hemicolectomies and 1 sigmoidectomy. Colonic carcinoma is more likely to be malignant in lymphatic, vascular and liver metastases and the prognosis is dismal. These tumors showed light microscopic and immunohistochemical evidence of adenocarcinomatous areas, and neuroendocrine differentiation demonstrated by positive neuronspecific enolase (NSE), synaptophysin, and chromogranin-A staining. Neuroendocrine carcinoma has the least favorable prognosis and surgical treatment alone cannot provide a cure. When undifferentiated carcinoma or poorly differentiated adenocarcinoma is indicated for colorectal lesions at biopsy, aggressive exploration entertaining a possible existence of the disease is essential. Effective multimodal therapy should include operation and chemotherapy.

Key words
neuroendocrine carcinoma, colon cancer

Reprint requests
Yasuhiro Kouchi Department of Surgery, Social Insurance Tokuyama Central Hopital 1-1 Kodacho, Tokuyama, 745-8522 JAPAN

Accepted
January 22, 2003

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