A CASE OF ENDOCRINE CELL CARCINOMA OF THE ASCENDING COLON

A 74-year-old woman was seen at the hospital because of right hypochondralgia and back pain. A barium enema study and a colonoscopic examination showed an elevated lesion in the ascending colon, and endocrine cell carcinoma was suspected after examination of a biopsy specimen. An abdominal CT scan revealed multiple liver metastases. NSE, a tumor marker, was elavated to 610ng/ml. Ileocecal resection was performed with a diagnosis of cancer of the ascending colon with liver metastasis. Histologically, the tumor consisted of polygonal-shaped cells and grew in a solid pattern without gland formation. Immunohistochemically, tumor cells were positive for NSE and for Synapto-physin, and weakly positive for Chromogranin A. Electron-microscopically, these cells were found to have numerous neurosecretory granules in their cytoplasm. The tumor was conclusively diagnosed as endocrine cell carcinoma. The patient was died of liver failure 39 days after the operation. In a review of the Japanese literature, many cases of colorectal endocrine cell carcinoma have been reported with metastasis of lymph nodes and other organs at diagnosis. In addition to operation, intestive treatment with chemotherapy and radiotherapy are necessary for patients with colorectal endocrine cell carcinoma.