Abstract
Gastrointestinal neuroendocrine tumor (NET) associated with a metachronous intestinal adenocarcinoma is rare. We report the case of a 71-year-old man with an ileal NET. Patient has previously undergone a left colectomy for sigmoid cancer. We report a complete review both of the metachronous and synchronous NET. A comprehensive systematic literature search in PubMed, EMBASE, and MEDLINE identified a total of 35 relevant studies. This study includes an analysis of review articles, case reports, case series, retrospective studies and population-based studies. In the English literature to date, there are 21 case reports (19 synchronous cases and 2 metachronous cases), 3 case series and 3 review articles, and less than 10 retrospective studies or population-based studies. A total of 31 patients in 24 articles were included in the study: 28 patients with a synchronous gastrointestinal NET and colorectal adenocarcinoma and 3 patients with metachronous gastrointestinal NET and colorectal adenocarcinoma. The incidence of synchronous cancer (particularly for colorectal and gastric cancer) with a gastrointestinal NET ranges from 10 to 50%, while for the metachronous ones it is still unclear. This is the third metachronous case report and the first descriptive case of gastrointestinal NET diagnosed 2 years after a colorectal adenocarcinoma. An endoscopic follow-up program for gastrointestinal NET patients and/or for first-degree relatives of NET patients appears recommendable.
Highlights
Neuroendocrine tumors of the small intestine represent the most common small-bowel neoplasms (31–41% of all small-bowel malignancies), 13% of all neuroendocrine tumor (NET) and 40% of the gastrointestinal NETs [1, 2]
A total of 31 patients in 24 articles were included in the study: 28 patients with a synchronous gastrointestinal NET and colorectal adenocarcinoma (Table 1) and 3 patients of 3 articles with metachronous gastrointestinal NET and colorectal adenocarcinoma (Table 2)
The adenocarcinoma location was: sigmoid colon (35.5%, 11 patients), right colon (25.8%, 8 patients), rectum (12.9%, 4 patients), left colon (9.7%, 3 patients), hepatic flexure (6.5%, 2 patients), splenic flexure (3.2%, 1 patient), transverse colon (3.2%, 1 patient), and small bowel (3.2%, 1 patient)
Summary
Neuroendocrine tumors of the small intestine (ileal NETs) represent the most common small-bowel neoplasms (31–41% of all small-bowel malignancies), 13% of all NETs and 40% of the gastrointestinal NETs [1, 2]. The incidence is estimated at about 1–2 cases/100,000 inhabitants/year [3]. The most frequent NET location is the terminal part of the small intestine [4], in particular the last 60 cm, and in 33% of the cases they are multiple along with the tenuous. The survival at 5 years after diagnosis of NET of the non-metastatic small intestine is 65% [4]. Several population-based studies show that patients with gastrointestinal NETs may have an associated metachronous primary tumor and vice versa [6]. The literature reports only two cases of metachronous NET
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