Abstract
A 50-year-old woman who presented with melena was diagnosed with a liver tumor by ultrasonography. Upper gastrointestinal endoscopy revealed multiple nodules in the gastric body, which were diagnosed as gastric carcinoids by biopsy. Colonoscopy revealed a rectal tumor (Ra lesion) that was diagnosed as both adenocarcinoma and neuroendocrine carcinoma (NEC) by biopsy. Computed tomography revealed para rectal lymph node metastases and a 60-mm tumor in the right liver lobe (S4). Furthermore, neuron-specific enolase levels were increased to 45.8 ng/ml. Low anterior and partial liver resections (S4) were performed. Histopathological examination confirmed the rectal and liver tumors to be NECs with a high mitotic rate and Ki-67 labeling index. Immunohistochemical staining for chromogranin, synaptophysin, and CD56 was positive. A final diagnosis of rectal NEC with liver metastasis comorbid with G1 gastric carcinoids was made according to the WHO classification. The patient remains recurrence-free 1 year after surgery. Herein, we report the first case, to our knowledge, of rectal NEC with liver metastasis comorbid with gastric carcinoids, and we discuss the relevant literature.
