Rectal Neuroendocrine Tumour with an Aggressive Behaviour

  1. Home
  2. Articles

Rectal Neuroendocrine Tumour with an Aggressive Behaviour

Augustin Marian Marincas, Virgiliu Prunoiu, Eugen Bratucu, Tudor Proca, Sinziana Ionescu
Clinical case, no. 3, 2021
Article DOI: 10.21614/chirurgia.116.3.368
Neuroendocrine tumors are rare epithelial neoplasms with the specific biological characteristics which can make the diagnosis and treatment questionable, and, which in general, have a good prognosis. In recent decades, the incidence of rectal neuroendocrine tumors has increased due to the accessibility of colonoscopy and the introduction of screening programs for colorectal tumors.
We present the case of a 55-year-old patient who presented for rectal bleeding started 6 months before. At the moment of the hospital admission, the general state of the patient was good, and the clinical and paraclinical examination confirmed the diagnosis of stage IV rectal tumor. The pathology examination could not distinguish between a non-differentiated carcinoma and a neuroendocrine tumor. The diagnosis of Rectal neuroendocrine tumor with an aggressive behaviour was established via immunohistochemistry (ki 67 index of 75-80%, G3 grading). Due to the high aggressiveness of the tumor, the patient had a rapid evolution towards a severe state and the onset of liver failure did not allow the systemic anti-tumor treatment.

In conclusion, we can state that in the case of rectal neuroendocrine tumors, the stage of the disease and the ki67 index have an important prognostic value, and it is crucial for both the diagnosis and tumor aggressiveness to have an immunohistochemical examination. Even though, in general, they are small well-differentiated tumors with a rather good prognosis, there are forms with tumors of greater dimensions and with metastases and severe prognosis.

Keywords: neuroendocrine tumor, rectal tumor