内容紹介
Summary
We report a case of effective treatment comprising mFOLFOX6 plus bevacizumab for neuroendocrine carcinoma of the ascending colon. A 60-year-old woman was admitted for diarrhea and abdominal pain. Colonoscopy showed a Type 2 tumor in the ascending colon. She was diagnosed with neuroendocrine cell carcinoma based on biopsy and immunostaining. CT and MRI showed liver metastasis and lymph node #12a metastasis. Right hemi-colectomy, lymphadenectomy, and partial hepatectomy were performed(T4a, N2, M1b, Stage Ⅳ). Neuroendocrine cell carcinoma(small-cell type)was finally diagnosed based on a histological examination because the nuclear fission image was 30(/10 HPF)and the Ki-67 index was 42%. Three months after the surgery, multiple lymph node metastases were found using CT and MRI. mFOLFOX6 plus bevacizumab was initiated. After 4 courses of the chemotherapy, the metastases responded completely. A total of 10 courses of chemotherapy were administered. About 2 years and 6 months after the surgery, no recurrence is allowed.
要旨
今回われわれは,化学療法が完全奏効している上行結腸神経内分泌細胞癌(neuroendocrine carcinoma: NEC)の1例を経験したので報告する。患者は60歳,女性。大腸内視鏡で上行結腸に2型腫瘍を認め,生検はG5であった。免疫染色を行い,NECと診断した。CT,MRIで胆囊周囲にリンパ節腫大,肝S6に腫瘍性病変を認めた。結腸右半切除,腫大していたリンパ節の摘出,肝部分切除を施行した。病理では小細胞癌様の腫瘍細胞が胞巣状に増生しており,核分裂像数は30(/10 HPF)で,Ki-67指数は42%であり,NEC(small-cell type)と診断した。術後3か月で肝門部リンパ節,腸間膜リンパ節に転移を来し,bevacizumab(Bev)併用mFOLFOX6を4コース施行したところ,リンパ節腫大は消失しCRと診断した。計10コース施行したが,再発は認めなかった。術後2年6か月経過したが,再発を認めていない。
目次
We report a case of effective treatment comprising mFOLFOX6 plus bevacizumab for neuroendocrine carcinoma of the ascending colon. A 60-year-old woman was admitted for diarrhea and abdominal pain. Colonoscopy showed a Type 2 tumor in the ascending colon. She was diagnosed with neuroendocrine cell carcinoma based on biopsy and immunostaining. CT and MRI showed liver metastasis and lymph node #12a metastasis. Right hemi-colectomy, lymphadenectomy, and partial hepatectomy were performed(T4a, N2, M1b, Stage Ⅳ). Neuroendocrine cell carcinoma(small-cell type)was finally diagnosed based on a histological examination because the nuclear fission image was 30(/10 HPF)and the Ki-67 index was 42%. Three months after the surgery, multiple lymph node metastases were found using CT and MRI. mFOLFOX6 plus bevacizumab was initiated. After 4 courses of the chemotherapy, the metastases responded completely. A total of 10 courses of chemotherapy were administered. About 2 years and 6 months after the surgery, no recurrence is allowed.
要旨
今回われわれは,化学療法が完全奏効している上行結腸神経内分泌細胞癌(neuroendocrine carcinoma: NEC)の1例を経験したので報告する。患者は60歳,女性。大腸内視鏡で上行結腸に2型腫瘍を認め,生検はG5であった。免疫染色を行い,NECと診断した。CT,MRIで胆囊周囲にリンパ節腫大,肝S6に腫瘍性病変を認めた。結腸右半切除,腫大していたリンパ節の摘出,肝部分切除を施行した。病理では小細胞癌様の腫瘍細胞が胞巣状に増生しており,核分裂像数は30(/10 HPF)で,Ki-67指数は42%であり,NEC(small-cell type)と診断した。術後3か月で肝門部リンパ節,腸間膜リンパ節に転移を来し,bevacizumab(Bev)併用mFOLFOX6を4コース施行したところ,リンパ節腫大は消失しCRと診断した。計10コース施行したが,再発は認めなかった。術後2年6か月経過したが,再発を認めていない。