A CASE OF COLON MIXED ADENONEUROENDOCRINE CARCINOMA PRESENTING WITH HEMATOCHEZIA: REPORT OF A CASE

Abstract

A 79-year-old male patient was transported to our emergency department due to loss of consciousness and hematochezia. Under the diagnosis of hemorrhagic shock, he underwent emergent colonoscopy. A tumorous lesion was found in the ascending colon and the site of active bleeding was confined to the lesion. Endoscopic mucosal resection (EMR) was performed with the aim of hemostasis, and pathological examination of the resected specimen revealed mixed adenoneuroendocrine carcinoma (MANEC). Since the tumor had invaded the muscularis propria, additional laparoscopic ileocecal resection with D3 lymph node dissection was performed. The pathological diagnosis of the tumor was pT2 pN1 M0, stage Ⅲa carcinoma, and postoperatively the patient received 8 courses of adjuvant XELOX chemotherapy. Colon MANEC is associated with early lymph node and distant organ metastases, and is resistant to multimodal and multidisciplinary treatments leading to an unfavorable prognosis. This report describes a case of colon MANEC presenting with hemorrhage as the initial symptom.