A case of small intestinal neuroendocrine carcinoma diagnosed using double-balloon endoscopy with long-term survival

Abstract

Neuroendocrine neoplasms, including neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs), are rare epithelial tumors with a predominant neuroendocrine differentiation. Compared with NETs, NECs have been reported to be rarer and have a poorer prognosis. We present a rare case of small bowel NEC diagnosed using double-balloon endoscopy (DBE) and the long-term survival accomplished via intensive therapy. DBE revealed an ulcerative tumor in the deep jejunum, and biopsy specimens showed large and highly dysplastic tumor cells; immuno-histological synaptophysin and chromogranin A tests were positive, and the Ki-67 index was more than 90%. Partial intestinal resection without complete lymph node dissection was performed and, postoperatively, chemotherapy was administered. The patient was observed for 3 years after chemotherapy, and complete remission was maintained.

Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy

“…Moreover, BAE enables direct observation of these small intestinal lesions, and also permits biopsy and endoscopic therapy, such as stent placement and endoscopic tattooing for subsequent surgical therapy[5,6]. A previous study reported the incidence of small intestinal tumors detected by BAE[6,7]; however, the endoscopic characteristics of small intestinal tumors have been reported only in a limited number of case reports[8-10], and the details of these characteristics are still unknown.…”