Niedrożność przewodu pokarmowego spowodowana rakiem neuroendokrynnym okrężnicy – opis przypadku

*Dariusz Wójcicki¹, Szymon Głowacki¹, Karol Łukasiak¹, Tomasz Pokładowski¹, Zbigniew Suwała¹, Michał Kwiatkowski²

Summary
Neuroendocrine neoplasms (NEN) comprise a rare pathology of the colon. Despite different etiology, their macroscopic appearence and clinical course in advanced stages present no difference when compared to adenocarcinoma. However, characteristic morphology of early stage NEN’s gives rise to suspicion towards this entity. The usual size of NEN’s at the time of discovery is 5 cm, thus becoming a possible cause for colon obstruction. The authors wish to present a case of 62 years old male patient operated on in the acute care settings due to colon obstruction and perforation caused by Neuroendocrine Carcinoma. The operation involved right hemicolectomy with ileostomy. The postoperative period was uneventful, the patient was discharged on the tenth day with further instructions for oncological treatment. Histopathology results revealed large cell neuroendocrine carcinoma G3 with a 10% component of adenocarcinoma.
Conclusions. 1. Due to a noncharacteristic course of illness, colonic NEN’s are diagnosed in a highly advanvced stage of the disease. 2. The necessity for additional staining methods renders the intraoperative specimen examination equivocal. 3. Suspicion for NEN intraoperatively does not change the treatment modality and it requires the same operative course as in the case of adenocarcinoma.

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