Document Type : Case Report(s)

Author

Surgery Department, Qom University of Medical Sciences, Qom, Iran

Abstract

A 76-year-old woman presented with a one-year history of intermittent right lower abdominal pain, little weight loss, and palpable mass in the right lower quadrant of the abdomen. Pelvic ultrasound scan identified a lobulated hypo-hetero-echoic mass with some calcified foci. Computed tomography scan revealed a low-attenuated lesion-like mass in the perineal region, which suggested a cystic localized tumor. Colonoscopy showed sub-mucosal lesion in the cecum. The patient underwent laparotomy, and a right hemicolectomy (include ileum) with ileocolic anastomosis was performed. She was treated successfully. In the Histological examination, two mass-like lesions were found to attach to the appendix. In the proximal portion of the appendix, there were cystic structures that showed a low-grade appendiceal mucinous neoplasm. The tip of the appendix showed a well-differentiated neuroendocrine tumor (carcinoid tumor). In this unusual case, even though the initial origins of these two tumors are quite different, two tumors appeared in a single histological section.

Keywords

How to cite this article:

Eshagh Hoseini SJ. Synchronous neuroendocrine tumor and mucinous tumor of the appendix in a 76-year-old woman. Middle East J Cancer. 2022;13(4):723-8. doi:10.30476 /mejc.2021.89175.1510.

1.Aydiner A, Karadeniz A, Uygun K, Tas S, Tas F, Disci R, et al. Multiple primary neoplasms at a single institution: differences between synchronous and metachronous neoplasms. Am J Clin Oncol. 2000;23(4):364-70. doi: 10.1097/00000421-200008000-00011.
2. Demandante CG, Troyer DA, Miles TP. Multiple primary malignant neoplasms: case report and a comprehensive review of the literature. Am J Clin Oncol. 2003;26(1):79-83. doi: 10.1097/00000421-200302000-00015.
3. Guzman C, Boddhula S, Panneerselvam N, Dodhia C, Hellenthal NJ, Monie D, et al. Appendiceal carcinoid tumors: Is there a survival advantage to colectomy over appendectomy? J Gastrointest Surg. 2020;24(5): 1149-57. doi: 10.1007/s11605-019-04306-w.
4. Bartlett DJ, Thacker PG Jr, Grotz TE, Graham RP, Fletcher JG, VanBuren WM, et al. Mucinous appendiceal neoplasms: classification, imaging, and HIPEC. Abdom Radiol (NY). 2019;44(5):1686-702. doi: 10.1007/s00261-018-01888-y.
5. Moslemi MK, Hosseini SJ, Joorabchin SM. Severe dyspnea due to pulmonary metastasis of renal cell carcinoma: Is cytoreductive surgery of value? Case Rep Oncol. 2010;3(3):339-43. doi: 10.1159/000321263.
6. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271-89. doi: 10.3322/caac.21349.
7. Lancellotti F, Solinas L, Telesco D, Sagnotta A, Belardi A, Balsamo G, et al. A rare case of metachronous neuroendocrine tumor after a colorectal adenocarcinoma: qualitative critical review of synchronous and metachronous gastrointestinal NET. Clin J Gastroenterol. 2021;14(1):115-22. doi: 10.1007/s12328-020-01255-9.
8. Winn JN, Sathyamurthy A, Kneib JL, Ibdah JA, Tahan V. Synchronous gastrointestinal carcinoid tumor and colon adenocarcinoma: Case reports and literature review. Am J Case Rep. 2017;18:626-30. doi: 10.12659/ ajcr.903580.
9. Reim D, Weirich G, Neu B, Bajbouj M, Brücher BL. Synchronous adenocarcinoma of the lung and neuroendocrine carcinoma of the ileum. Int J Colorectal Dis. 2008;23(3):325-7. doi: 10.1007/s00384-007-0412-x.
10. Aoyagi K, Kizaki J, Isobe T, Akagi Y. A case of gastric cancer with neuroendocrine carcinoma, signet ring cell carcinoma components, and intramural metastases. Am J Case Rep. 2016;17:274-9. doi: 10.12659/ajcr. 896625.
11. Nader K, Mok S, Kalra A, Harb A, Schwarting R, Ferber A. Vanishing bile duct syndrome as a manifestation of Hodgkin's lymphoma: a case report and review of the literature. Tumori. 2013;99(4):e164-8. doi: 10.1700/1361.15117.
12. Cioffi U, De Simone M, Ferrero S, Ciulla MM, Lemos A, Avesani EC. Synchronous adenocarcinoma and carcinoid tumor of the terminal ileum in a Crohn's disease patient. BMC Cancer. 2005;5:157. doi: 10.1186/1471-2407-5-157.
13. Armah HB, Parwani AV, Perepletchikov AM. Synchronous primary carcinoid tumor and primary adenocarcinoma arising within mature cystic teratoma of horseshoe kidney: a unique case report and review of the literature. Diagn Pathol. 2009;4:17. doi: 10.1186/1746-1596-4-17.
14. Yamauchi H, Sakurai S, Tsukagoshi R, Suzuki M, Tabe Y, Fukasawa T, et al. A case of very well-differentiated adenocarcinoma with carcinoid tumor in the ascending colon. Int Surg. 2014;99(2):132-6. doi: 10.9738/INTSURG-D-13-00041.1.
15. Reid MD, Basturk O, Shaib WL, Xue Y, Balci S, Choi HJ, et al. Adenocarcinoma ex-goblet cell carcinoid (appendiceal-type crypt cell adenocarcinoma) is a morphologically distinct entity with highly aggressive behavior and frequent association with peritoneal/intra-abdominal dissemination: an analysis of 77 cases. Mod Pathol. 2016;29(10):1243-53. doi: 10.1038/ modpathol.2016.105.
16. Hosseini SJE, Tizmaghz A, Andalib B, Shabestanipour G. Rectal necrosis: A rare complication of palliative radiotherapy for sacral spine metastasis. Journal of Clinical and Diagnostic Research. 2018;12(5):XD01-XD2. doi: 10.7860/JCDR/2018/35373.11510.