Colorectal mixed adenoneuroendocrine carcinoma (MANEC): report of four cases

doi:10.3877/cma.j.issn.2095-3224.2018.04.018

Abstract

Abstract:

Mixed adenoneuroendocrine carcinoma (MANEC) is an extremely rare tumor, composes of two components as adenocarcinoma and neuroendocrine tumor with each portion is no less than 30%. We present four cases of MANEC in colorectum, which showed different combination of two components. One was low grade neuroendocrine tumor (G1) with well-differentiated tubular adenocarcinoma. Three were high grade neuroendocrine carcinoma (G3) with moderate differentiated adenocarcinoma. The neuroendocrine part in MANEC showed deeper infiltration and more lymph node metastasis. And with different combination of two components in tumors, MANEC should be stratified in different prognostic categories according to the grade of malignancy of each component.

Key words: Colorectal neoplasms, Mixed adenoneuroendocrine carcinoma, Neuroendocrine tumor

Jian Guan, Shuangmei Zou. Colorectal mixed adenoneuroendocrine carcinoma (MANEC): report of four cases[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2018, 07(04): 393-397.

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References 8

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名称	病例1		病例2		病例3		病例4
名称	腺癌	神经内分泌肿瘤	腺癌	神经内分泌肿瘤	腺癌	神经内分泌肿瘤	腺癌	神经内分泌肿瘤
CK20	2+	点状+	3+	3+	3+	2+	3+	3+
CDX2	3+	-	3+	-	3+	-	3+	3+
CD56	-	2+	1+	-	1+	-	-	-
Syn	点状+	3+	-	1+	-	-	-	2+
CgA	点状+	1+	-	1+	-	点状+	-	点状+
Ki67	40%	<2%	50%	70%	70%	70%	50%	35%

名称	病例1		病例2		病例3		病例4
名称	腺癌	神经内分泌肿瘤	腺癌	神经内分泌肿瘤	腺癌	神经内分泌肿瘤	腺癌	神经内分泌肿瘤
CK20	2+	点状+	3+	3+	3+	2+	3+	3+
CDX2	3+	-	3+	-	3+	-	3+	3+
CD56	-	2+	1+	-	1+	-	-	-
Syn	点状+	3+	-	1+	-	-	-	2+
CgA	点状+	1+	-	1+	-	点状+	-	点状+
Ki67	40%	<2%	50%	70%	70%	70%	50%	35%

	病例1	病例2	病例3	病例4
性别	男	女	男	男
年龄	59	55	65	58
部位	直肠	升结肠	直肠	直肠
肿瘤大小（cm）	1.5×1.2×1.4	6×5.5×4	4.5×3.5×1	4×3×0.8
腺癌成分	高分化腺癌	中分化腺癌伴粘液分泌	中-低分化腺癌，部分呈印戒细胞癌	中分化腺癌
腺癌成分	pT2N0	pT2N0	pT2N0	pT3N0
神经内分泌肿瘤成分	G1	G3	G3	G3
	<2/10 HPF	>20/10 HPF	>20/10 HPF	>20/10 HPF
	Ki67<2%	Ki67 70%	Ki67 70%	Ki67 35%
	pT2N2b	pT4aN2b	pT4aN0	pT2N1b
淋巴结转移情况	12/27	11/43	0/17	3/14

	病例1	病例2	病例3	病例4
性别	男	女	男	男
年龄	59	55	65	58
部位	直肠	升结肠	直肠	直肠
肿瘤大小（cm）	1.5×1.2×1.4	6×5.5×4	4.5×3.5×1	4×3×0.8
腺癌成分	高分化腺癌	中分化腺癌伴粘液分泌	中-低分化腺癌，部分呈印戒细胞癌	中分化腺癌
腺癌成分	pT2N0	pT2N0	pT2N0	pT3N0
神经内分泌肿瘤成分	G1	G3	G3	G3
	<2/10 HPF	>20/10 HPF	>20/10 HPF	>20/10 HPF
	Ki67<2%	Ki67 70%	Ki67 70%	Ki67 35%
	pT2N2b	pT4aN2b	pT4aN0	pT2N1b
淋巴结转移情况	12/27	11/43	0/17	3/14

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