阑尾杯状细胞类癌合并回盲部混合型腺神经内分泌癌1例病例报道并文献复习

目的:报道1例极为罕见的阑尾杯状细胞类癌(goblet cell carcinoid,GCC)合并回盲部混合型腺神经内分泌癌(mixed adenoneuroendocrine carcinoma,MANEC),以提高临床医师对本病的认识。方法:回顾性分析1例阑尾GCC合并回盲部MANEC患者的临床、病理特征、免疫组化及术后情况并进行文献复习。结果:该病例经病理切片会诊明确诊断为GCC,行右半结肠切除术后进一步诊断为回盲部MANEC,行1次FOLFOX化疗后,一般情况良好。结论:阑尾GCC合并回盲部MANEC是具有高度侵袭性的异质性恶性肿瘤,免疫组化局部Cg A和局部Syn阳性、Tang分类C组、临床分期IV期和非根治性手术为不良预后的危险因素。

Goblet Cell Carcinoid of the Appendix with Hysteretic Mixed Adenoneuroendocrine Carcinoma: a Case Report and Literature Review

ABSTRACT Objective: To report an extremely rare case of appendiceal GCC with hysteretic MANEC that in order to improve clin- icians'' understanding of this disease. Methods: The clinical manifestations, pathology, expression of immunohistochemistry and the post- operative conditions in a case of appendiceal GCC patients with hysteretic MANEC was retrospectively analyzed and the related litera- ture was reviewed. Results: The case was diagnosed as GCC by pathological section consultation, and further diagnosed as hysteretic MANEC after right hemicolectomy. After one cycle of FOLFOX chemotherapy, the general condition was good. Conclusion: The appen- diceal GCC with hysteretic MANEC is a highly invasive heterogeneous malignant tumor. Focally positive staining pattern for CgA and Syn, Tang group C, clinical stage IV and non-radical surgery are risk factors for the poor prognosis.