Neuroendorine tumor in the background of adenocarcinoma of midrectum
Introduction: Synchronous neuroendocrine tumor in the background of midrectal adenocarcinoma is rare. It is a very slow-growing tumor and symptomatic only late in the course of the disease. Case Summary: This is a 60 years old gentleman with no past medical illness presented with persistent lo...
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| Format: | Proceeding Paper |
| Language: | English English |
| Published: |
2015
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/58385/ http://irep.iium.edu.my/58385/13/58385.pdf http://irep.iium.edu.my/58385/2/poster%20net%20rectum.pdf |
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| author | Mahno, Noor Ezmas Ong, David B, Mohd Nurshamizam Md Nor, Azmi |
| author_facet | Mahno, Noor Ezmas Ong, David B, Mohd Nurshamizam Md Nor, Azmi |
| author_sort | Mahno, Noor Ezmas |
| building | IIUM Repository |
| collection | Online Access |
| description | Introduction:
Synchronous neuroendocrine tumor in the background of midrectal adenocarcinoma is
rare. It is a very slow-growing tumor and symptomatic only late in the course of the
disease.
Case Summary:
This is a 60 years old gentleman with no past medical illness presented with persistent
loose stool with mucus for 3 months. Colonoscopy found clinically not obstructed upper
rectal tumor and biopsy came back as adenocarcinoma. CEA was not raised. CT scan
staging showed no distant metastasis and MRI staging reported as T3N0. Intraoperatively,
we found midrectal tumor with mucosal ulceration and small liver nodule at segment
V. Low anterior resection encompassed of good oncological resection with covering ileostomy
was done. Moderately differentiated adenocarcinoma of midrectum with staging
of p T2 N0 Mx.
Initially, the pathologist reported as the distal doughnut of the specimen was involved.
However, after consultation with few experienced pathologist noted an incidental neuroendocrine
tumor, grade 1 at the distal doughnut of the specimen with positive immunohistochemical
staining for synaptophysin, chromogranin and CD56. Histologically,
there were solid nest and occasional rosette of neoplastic cells confined within the submucosal
layer, sparing the overlying mucosa. There was no necrosis or muscularis propria
invasion. Mitotic figure is low, around 0-1/10 high power field. The Ki67 proliferative
index is about 1%. PET scan was arranged to confirm the suspicious liver nodule to
rule out metastasis. Serum chromogranin A was pending. He was arranged for oncology
review after the PET scan for further plan. |
| first_indexed | 2025-11-14T16:47:48Z |
| format | Proceeding Paper |
| id | iium-58385 |
| institution | International Islamic University Malaysia |
| institution_category | Local University |
| language | English English |
| last_indexed | 2025-11-14T16:47:48Z |
| publishDate | 2015 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | iium-583852017-09-26T06:58:32Z http://irep.iium.edu.my/58385/ Neuroendorine tumor in the background of adenocarcinoma of midrectum Mahno, Noor Ezmas Ong, David B, Mohd Nurshamizam Md Nor, Azmi RD Surgery Introduction: Synchronous neuroendocrine tumor in the background of midrectal adenocarcinoma is rare. It is a very slow-growing tumor and symptomatic only late in the course of the disease. Case Summary: This is a 60 years old gentleman with no past medical illness presented with persistent loose stool with mucus for 3 months. Colonoscopy found clinically not obstructed upper rectal tumor and biopsy came back as adenocarcinoma. CEA was not raised. CT scan staging showed no distant metastasis and MRI staging reported as T3N0. Intraoperatively, we found midrectal tumor with mucosal ulceration and small liver nodule at segment V. Low anterior resection encompassed of good oncological resection with covering ileostomy was done. Moderately differentiated adenocarcinoma of midrectum with staging of p T2 N0 Mx. Initially, the pathologist reported as the distal doughnut of the specimen was involved. However, after consultation with few experienced pathologist noted an incidental neuroendocrine tumor, grade 1 at the distal doughnut of the specimen with positive immunohistochemical staining for synaptophysin, chromogranin and CD56. Histologically, there were solid nest and occasional rosette of neoplastic cells confined within the submucosal layer, sparing the overlying mucosa. There was no necrosis or muscularis propria invasion. Mitotic figure is low, around 0-1/10 high power field. The Ki67 proliferative index is about 1%. PET scan was arranged to confirm the suspicious liver nodule to rule out metastasis. Serum chromogranin A was pending. He was arranged for oncology review after the PET scan for further plan. 2015 Proceeding Paper NonPeerReviewed application/pdf en http://irep.iium.edu.my/58385/13/58385.pdf application/pdf en http://irep.iium.edu.my/58385/2/poster%20net%20rectum.pdf Mahno, Noor Ezmas and Ong, David and B, Mohd Nurshamizam and Md Nor, Azmi (2015) Neuroendorine tumor in the background of adenocarcinoma of midrectum. In: Coloproctology 2015 International Scientific Meeting, 12th-15th March 2015, Melaka. (Unpublished) http://colorectalmy.org/Coloproctology2015/download/Coloproctology2015_SPAB.pdf |
| spellingShingle | RD Surgery Mahno, Noor Ezmas Ong, David B, Mohd Nurshamizam Md Nor, Azmi Neuroendorine tumor in the background of adenocarcinoma of midrectum |
| title | Neuroendorine tumor in the background
of adenocarcinoma of midrectum |
| title_full | Neuroendorine tumor in the background
of adenocarcinoma of midrectum |
| title_fullStr | Neuroendorine tumor in the background
of adenocarcinoma of midrectum |
| title_full_unstemmed | Neuroendorine tumor in the background
of adenocarcinoma of midrectum |
| title_short | Neuroendorine tumor in the background
of adenocarcinoma of midrectum |
| title_sort | neuroendorine tumor in the background
of adenocarcinoma of midrectum |
| topic | RD Surgery |
| url | http://irep.iium.edu.my/58385/ http://irep.iium.edu.my/58385/ http://irep.iium.edu.my/58385/13/58385.pdf http://irep.iium.edu.my/58385/2/poster%20net%20rectum.pdf |