A rare case of metachronous neuroendocrine tumor after a colorectal adenocarcinoma: qualitative critical review of synch
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CASE REPORT
A rare case of metachronous neuroendocrine tumor after a colorectal adenocarcinoma: qualitative critical review of synchronous and metachronous gastrointestinal NET Francesco Lancellotti1 · Luigi Solinas2 · Davide Telesco3 · Andrea Sagnotta2 · Augusto Belardi2 · Giuseppina Balsamo4 · Stefano Mancini2 Received: 25 June 2020 / Accepted: 19 September 2020 © The Author(s) 2020
Abstract Gastrointestinal neuroendocrine tumor (NET) associated with a metachronous intestinal adenocarcinoma is rare. We report the case of a 71-year-old man with an ileal NET. Patient has previously undergone a left colectomy for sigmoid cancer. We report a complete review both of the metachronous and synchronous NET. A comprehensive systematic literature search in PubMed, EMBASE, and MEDLINE identified a total of 35 relevant studies. This study includes an analysis of review articles, case reports, case series, retrospective studies and population-based studies. In the English literature to date, there are 21 case reports (19 synchronous cases and 2 metachronous cases), 3 case series and 3 review articles, and less than 10 retrospective studies or population-based studies. A total of 31 patients in 24 articles were included in the study: 28 patients with a synchronous gastrointestinal NET and colorectal adenocarcinoma and 3 patients with metachronous gastrointestinal NET and colorectal adenocarcinoma. The incidence of synchronous cancer (particularly for colorectal and gastric cancer) with a gastrointestinal NET ranges from 10 to 50%, while for the metachronous ones it is still unclear. This is the third metachronous case report and the first descriptive case of gastrointestinal NET diagnosed 2 years after a colorectal adenocarcinoma. An endoscopic follow-up program for gastrointestinal NET patients and/or for first-degree relatives of NET patients appears recommendable. Keywords Metachronous neuroendocrine · Synchronous NET · Colorectal adenocarcinoma · Coexisting tumors · Gastrointestinal carcinoids
Background Neuroendocrine tumors of the small intestine (ileal NETs) represent the most common small-bowel neoplasms (31–41% of all small-bowel malignancies), 13% of all NETs
and 40% of the gastrointestinal NETs [1, 2]. The incidence is estimated at about 1–2 cases/100,000 inhabitants/year [3]. The most frequent NET location is the terminal part of the small intestine [4], in particular the last 60 cm, and in 33% of the cases they are multiple along with the tenuous
* Francesco Lancellotti [email protected]
Stefano Mancini [email protected]
Luigi Solinas [email protected]
1
Davide Telesco [email protected]
Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
2
Andrea Sagnotta [email protected]
Department of General Surgery and Surgical Oncology, San Filippo Neri Hospital, Rome, Italy
3
Augusto Belardi [email protected]
Department of General Surgery, Surgical Specialities “Paride Stefanini”, Sapienza University of Rome, Rome,
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