A case report of neuroendocrine tumor (G3) at lower rectum with liver metastasis

Abstract

Rationale:Rectal neuroendocrine tumor is a rare disease that is difficult to diagnose by clinical and imageological examinations. The treatment of rectal neuroendocrine tumors is still controversial.Patient concerns:A 50-year-old woman complained of abdominal pain beneath the xiphoid process for 1 day. Physical checkup revealed tenderness at the right upper abdomen. A fecal occult blood test was positive. MRI showed an occupation lesion in the right lobe of the liver. Colonoscopy examination showed a lesion at the lower rectum with an ulcerated surface that was tough in texture. No abnormality was found in the tumor markers.Diagnosis:Rectal neuroendocrine tumor (G3) with liver metastasis.Interventions:Neoadjuvant chemotherapy followed by laparoscopic surgery was given.Outcomes:The patient followed up regularly in the outpatient department for 13 months after surgery, and no sign of recurrence was found.Lessons:Neoadjuvant chemotherapy followed by laparoscopic surgery is a new idea for the treatment of rectal neuroendocrine carcinoma with distant metastasis, which offers favorable conditions for saving the anus during the surgery to enhance the patient's quality of life.

When is neoadjuvant chemotherapy indicated in rectal neuroendocrine tumors? An analysis of the National Cancer Database

“…Our study did not find any significant survival benefit in treating patients with large T4 tumors and metastatic disease with neoadjuvant chemotherapy. A previous case report aligns with our finding [ 20 ]. This report described the treatment of a female patient with high-grade rNET and liver metastasis with neoadjuvant chemotherapy, which was effective in downgrading the rectal tumor but did not result in significant changes in the size of the lesions at the rectum and liver [ 20 ].…”

“…A previous case report aligns with our finding [ 20 ]. This report described the treatment of a female patient with high-grade rNET and liver metastasis with neoadjuvant chemotherapy, which was effective in downgrading the rectal tumor but did not result in significant changes in the size of the lesions at the rectum and liver [ 20 ]. Overall, the value of neoadjuvant therapy in metastatic disease is unclear with no unequivocal recommendations.…”