Neuroendocrine Tumor of Cecum-Well Differentiated Intermediate Grade: G2 Presented with Aggressive Biologic Behavior: Case Report with Review

Abstract

Neuroendocrine tumors (NETs) are relatively rare neoplasms of the gastrointestinal tract with variable clinical presentations. A 53 year old female presented with a chief complaint of intermittent right-sided abdominal pain, nausea, loose stools of and on of 8 month duration. The computed tomography of abdomen and pelvis, both plain and with contrast revealed the presence of a large well defined homogenously enhancing polypoidal mass lesion noted in the caecum measuring 2.8 X 2.6 X 2.8 cm in size. On colonoscopy revealed the presence of a polypiodal mass in the cecum measuring 3 cm with mucosal ulceration. The biopsy reported as suggestive of neuroendocrine tumor. The wide surgical resection of cecal mass with lymph node dissection was done. On histopatholgy reported as well differentiated neuroendocrine tumor, intermediate grade G2 of cecum with mesenteric lymph node metastasis. On clinical of stage III. The tumor was strong and diffusely positive for expression of synaptophysin and chromogranin A. The expression of the cell-cycle-associated Ki-67 antigen by MIB-1 monoclonal antibody was 3%. Herewith we are presenting rare case of well differentiated neuroendocrine tumor with intermediate grade or grade 2 of cecum with aggressive biologic behavior.