内容紹介
Long-Term Survival of a Patient with Rectal Neuroendocrine Carcinoma after Treatment with Curative Resection and Adjuvant Chemotherapy with Capecitabine
Summary
A 63-year-old man who complained of hematochezia underwent colonoscopy, and a type 2 tumor was detected at the Rs portion. The tumor was initially diagnosed as a poorly differentiated adenocarcinoma by biopsy. Laparoscopy-assisted anterior resection with regional lymphadenectomy was performed, and pathological examination showed the tumor was a neuroendocrine carcinoma(NEC)with muscular invasion and lymph node metastasis. The Ki-67 index of the tumor was more than 70%. This patient underwent adjuvant chemotherapy with capecitabine for 6 months and is now alive without recurrence, more than 40 months after surgery. Although the prognosis of NEC is generally poor, capecitabine might be effective as an adjuvant chemotherapy regimen after curative resection.
要旨
症例は63歳,男性。血便を主訴に下部消化管内視鏡検査で直腸Rsに2型腫瘍を指摘され,生検で低分化型腺癌の診断を得た。腹腔鏡補助下前方切除を受け,切除標本の病理診断は直腸神経内分泌細胞癌(neuroendocrine carcinoma: NEC)で固有筋層浸潤があり,リンパ節転移陽性,Ki-67 index>70%であった。補助療法としてcapecitabineを6か月間投与し,40か月以上無再発生存中である。直腸NECの予後は不良で,確立された化学療法はないが,術後補助化学療法としてcapecitabineが有効である可能性が示された。
目次
Summary
A 63-year-old man who complained of hematochezia underwent colonoscopy, and a type 2 tumor was detected at the Rs portion. The tumor was initially diagnosed as a poorly differentiated adenocarcinoma by biopsy. Laparoscopy-assisted anterior resection with regional lymphadenectomy was performed, and pathological examination showed the tumor was a neuroendocrine carcinoma(NEC)with muscular invasion and lymph node metastasis. The Ki-67 index of the tumor was more than 70%. This patient underwent adjuvant chemotherapy with capecitabine for 6 months and is now alive without recurrence, more than 40 months after surgery. Although the prognosis of NEC is generally poor, capecitabine might be effective as an adjuvant chemotherapy regimen after curative resection.
要旨
症例は63歳,男性。血便を主訴に下部消化管内視鏡検査で直腸Rsに2型腫瘍を指摘され,生検で低分化型腺癌の診断を得た。腹腔鏡補助下前方切除を受け,切除標本の病理診断は直腸神経内分泌細胞癌(neuroendocrine carcinoma: NEC)で固有筋層浸潤があり,リンパ節転移陽性,Ki-67 index>70%であった。補助療法としてcapecitabineを6か月間投与し,40か月以上無再発生存中である。直腸NECの予後は不良で,確立された化学療法はないが,術後補助化学療法としてcapecitabineが有効である可能性が示された。