Rectal mixed adenoneuroendocrine carcinoma

Silva, D.; Santos, Joana Dos; Vaz, Ana Paula; Mesquita, Anabela

doi:10.1097/md.0000000000027348

Cited by 6 publications

(11 citation statements)

References 14 publications

(64 reference statements)

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“…Histologically, most cases are composed of adenocarcinoma and NEC. Rare cases in which the nonneuroendocrine component consisted of squamous cell carcinoma have also been noted[ 43 , 91 ]. If the neuroendocrine component consists of PDNEC, it is consistently observed in metastases.…”

Section: Organ-specific Clinicopathological Findingsmentioning

confidence: 99%

“…In comparison, adenocarcinomas are observed in one-third of cases[ 47 ]. Such tumors show aggressive behavior and have poor prognosis (overall survival: 12.2 mo) according to the Ki67 proliferative index of the NEC component as well as the MSI status and stage[ 42 , 43 , 67 ]. Recently, a systematic review demonstrated that if the neuroendocrine component consists of NETs, it is unknown which component will be encountered in metastatic sites because of a higher grade, and the predominance of one component does not warrant their presence in metastatic sites[ 47 , 92 , 93 ].…”

Section: Organ-specific Clinicopathological Findingsmentioning

confidence: 99%

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Mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system: An update

Elpek¹

2022

WJG

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Mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) of the digestive tract are a rare heterogeneous group of tumors that present many challenges in terms of diagnosis and treatment. Over the years, the diagnostic criteria, classification, and clinical behavior of these tumors have been the subjects of ongoing debate, and the various changes in their nomenclature have strengthened the challenges associated with MiNENs. This review is performed to provide an understanding of the key factors involved in the evolution of the designation of these tumors as MiNEN, highlight the current diagnostic criteria, summarize the latest data on pathogenesis and provide information on available treatments. Moreover, this work seeks to increase the awareness about these rare neoplasms by presenting the clinicopathological features and prognostic factors that play important roles in their behavior and discussing their different regions of origin in the gastrointestinal system (GIS). Currently, the MiNEN category also includes tumors in the GIS with a nonneuroendocrine component and epithelial tumors other than adenocarcinoma, depending on the organ of origin. Diagnosis is based on the presence of both morphological components in more than 30% of the tumor. However, this value needs to be reconfirmed with further studies and may be a limiting factor in the diagnosis of MiNEN by biopsy. Furthermore, available clinicopathological data suggest that the inclusion of amphicrine tumors in the definition of MiNEN is not supportive and warrants further investigation. The diagnosis of these tumors is not solely based on immunohistochemical findings. They are not hybrid tumors and both components can act independently; thus, careful grading of each component separately is required. In addition to parameters such as the metastatic state of the tumor at the time of diagnosis and the feasibility of surgical resection, the aggressive potential of both components has paramount importance in the choice of treatment. Regardless of the organ of origin within the GIS, almost MiNENs are tumors with poor prognosis and are frequently encountered in the elderly and men. They are most frequently reported in the colorectum, where data from molecular studies indicate a monoclonal origin; however, further studies are required to provide additional support for this origin.

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Section: Organ-specific Clinicopathological Findingsmentioning

confidence: 99%

Section: Organ-specific Clinicopathological Findingsmentioning

confidence: 99%

Mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system: An update

Elpek¹

2022

WJG

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“…Kolorektaliniai MiNEN (mišrūs neuroendokrininiai ir neneuroendokrininiai navikai, turintys ne mažiau kaip 30 proc. kiekvieno iš komponentų) apibūdinami kaip reti, biologiškai agresyvūs, prastos prognozės navikai, dažnai diagnozuojami esant pažengusiai stadijai [1]. Dėl jų retumo didžiąją kolorektalinius MiNEN anali zuojančios mokslinės literatūros dalį sudaro klinikinių atvejų aprašymai ir nedideli retrospektyviniai tyrimai, o galimybę geriau suvokti šią patologiją ir apibendrinti informaciją sunkina besikeičianti terminologija bei tvirto mokslinio pagrindo neturinčios komponentų santykio ribos, todėl kol kas nėra visuotinai priimtų bend rų gairių aptariamos patologijos epidemiologijai, patogenezei, gydymui ir prognozei apibūdinti.…”

Section: įVadasunclassified

Colorectal Neoplasm with Predominant Neuroendocrine Immunophenotype: Where does Adenocarcinoma End?

Cibulskaitė

Stulpinas

Poškus

et al. 2022

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MiNEN (mixed neuroendocrine-non-neuroendocrine neoplasm) is described in the 5th edition WHO classification of tumors of the digestive system as a mixed neoplasm, composed of neuroendocrine and non-neuroendocrine parts, each accounting for at least 30% of the tumor. Recently this formal criterion has been criticized based on the theory that both of these components could have a monoclonal origin and non-neuroendocrine cells develop neuroendocrinicity in the later evolutionary steps of adenocarcinoma. For this reason, the identification of pure adenocarcinoma component, that was overgrown by a more aggressive clone with neuroendocrine features, in a pathological specimen can be difficult and, in some cases, even impossible. So, it is likely that at least some of large cell neuroendocrine carcinomas follow the same pathway, a theory that is further supported by adenocarcinoma-like molecular alterations in these tumors. Precise diagnosis (which means identifying and naming each tumor component regardless of its size) is essential for a personalized treatment strategy. We present an illustrative case of a rectal neoplasm that could be classified as a poorly differentiated neuroendocrine carcinoma, but exhibits morphological heterogeneity, mucin production and has a typical KRAS mutation pointing to adenocarcinomatous origin, which makes MiNEN a more accurate diagnosis. The article discusses the key points in classification, pathogenesis, and diagnostic approach to help effectively manage such neoplasms.

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“…In 2019, malignant epithelial tumours of the colon and rectum were broadly of Digestive System tumours established that mixed neuroendocrine-nonneuroendocrine neoplasms were composed of at least 30% of each component and identified as "Mixed Adenoneuroendocrine Carcinomas (MANEC) [1].…”

Section: Introductionmentioning

confidence: 99%

Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm (MiNEN) of the Colon: A Case Report

Mohammad,

Alias

2024

OJPathology

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Here we report a rare case of mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs). A 51-year-old lady with no known family history of malignancies developed this rare type of malignancy without any active gastrointestinal symptoms. However, during a routine health check, physicians noticed a raised Carcinoembryonic Antigen (CEA) level and the patient subsequently was referred to the surgical department for further management. A colonoscopy and CECT abdomen were done and she was electively admitted for a left hemicolectomy operation for a splenic flexure tumour. The histopathological report revealed the tumour is a case of mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) [moderately differentiated adenocarcinoma and neuroendocrine tumour grade 3]. TNM (8th edition, 2016): pT3, pN2 (20/21), pMX. Both resection margins were clear from malignant cells. Colorectal MiNENs, constitute a rare group of gastrointestinal tumours composed of both neuroendocrine and non-neuroendocrine components. Given their non-diagnostic macroscopic features, specific histological features and lack of disease awareness which are responsible for the underestimated incidence and conflicting data. In this case, a multidisciplinary team approach is important in managing patients with this malignancy to achieve the best outcome.

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Rectal mixed adenoneuroendocrine carcinoma

Cited by 6 publications

References 14 publications

Mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system: An update

Mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system: An update

Colorectal Neoplasm with Predominant Neuroendocrine Immunophenotype: Where does Adenocarcinoma End?

Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm (MiNEN) of the Colon: A Case Report

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