| Title |
Storosios žarnos navikas, kuriam būdingas dominuojantis neuroendokrininis imunofenotipas: kur baigiasi adenokarcinoma? / |
| Translation of Title |
Colorectal neoplasm with predominant neuroendocrine immunophenotype: where does adenocarcinoma end? |
| Authors |
Cibulskaitė, Gabrielė ; Stulpinas, Rokas ; Poškus, Eligijus ; Tulytė, Skaistė ; Mickys, Ugnius |
| DOI |
10.15388/LietChirur.2022.21.58 |
| Full Text |
|
| Is Part of |
Lietuvos chirurgija.. Vilnius : Vilniaus universiteto leidykla. 2022, t. 21, Nr. 1, p. 56-64.. ISSN 1392-0995. eISSN 1648-9942 |
| Keywords [eng] |
mixed neuroendocrine non-neuroendocrine neoplasm ; MiNEN ; mixed adeno-neuroendocrine carcinoma MANEC ; large cell neuroendocrine carcinoma ; colorectal neoplasm. |
| Abstract [eng] |
MiNEN (mixed neuroendocrine-non-neuroendocrine neoplasm) is described in the 5th edition WHO classification of tumors of the digestive system as a mixed neoplasm, composed of neuroendocrine and non-neuroendocrine parts, each accounting for at least 30% of the tumor. Recently this formal criterion has been criticized based on the theory that both of these components could have a monoclonal origin and non-neuroendocrine cells develop neuroendocrinicity in the later evolutionary steps of adenocarcinoma. For this reason, the identification of pure adenocarcinoma component, that was overgrown by a more aggressive clone with neuroendocrine features, in a pathological specimen can be difficult and, in some cases, even impossible. So, it is likely that at least some of large cell neuroendocrine carcinomas follow the same pathway, a theory that is further supported by adenocarcinoma-like molecular alterations in these tumors. Precise diagnosis (which means identifying and naming each tumor component regardless of its size) is essential for a personalized treatment strategy. We present an illustrative case of a rectal neoplasm that could be classified as a poorly differentiated neuroendocrine carcinoma, but exhibits morphological heterogeneity, mucin production and has a typical KRAS mutation pointing to adenocarcinomatous origin, which makes MiNEN a more accurate diagnosis. The article discusses the key points in classification, pathogenesis, and diagnostic approach to help effectively manage such neoplasms. |
| Published |
Vilnius : Vilniaus universiteto leidykla |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2022 |
| CC license |
|
