Abstract
An 85-year-old woman, who underwent lower gastrointestinal endoscopy because her stools were positive for occult blood, was found to have an elevated lesion in the sigmoid colon. The histopathological diagnosis of a biopsied specimen was poorly differentiated adenocarcinoma. An abdominal CT scan performed in November 2007 when she was first seen showed no recognizable metastases to the liver, lung and lymph nodes. On November 15, 2007, sigmoidectomy + D2 dissection was performed with a diagnosis of cancer of the sigmoid colon. The final histopathological diagnosis was endocrine cell carcinoma, localized in the submucosal layer, N0 and StageI. Another CT scan performed on the 7th month after the operation revealed multiple hepatic metastases and pulmonary metastasis. Thereafter these metastatic lesions rapidly enlarged and eventually the patient died 9 months after the operation.
It has been reported that endocrine cell carcinoma of the large intestine is rare and carries poor prognosis. Although the disease in our patient was in StageI when she was operated on, multiple hepatic as well as pulmonary metastases occurred early after the operation and it progressed rapidly to its termination. This paper presents our case together with a review of the literature.
