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Ieni et al. J Cancer Metastasis Treat 2017;3:144-9 Journal of
DOI: 10.20517/2394-4722.2017.15
Cancer Metastasis and Treatment

www.jcmtjournal.com
Case Report Open Access

Uterine large cell neuroendocrine carcinoma

with unusual colonic metastasis

Antonio Ieni , Giuseppe Angelico , Rosalba De Sarro , Francesco Fleres , Antonio Macrì , Giovanni Tuccari 1
3
1
2
3
1
1 Department of Human Pathology of Adult and Evolutive Age “Gaetano Barresi”, Section of Anatomic Pathology, University of Messina, 98125 Messina, Italy.
2 Student in Medicine and Surgery, University of Messina, 98125 Messina, Italy.
3 Department of Human Pathology of Adult and Evolutive Age “Gaetano Barresi”, Section of General Surgery, University of Messina, Azienda Ospedaliera
Universitaria “Policlinico Gaetano Martino”, 98125 Messina, Italy.
Correspondence to: Prof. Giovanni Tuccari, Department of Human Pathology of Adult and Evolutive Age “Gaetano Barresi”, Section of Anatomic
Pathology, University of Messina, 98125 Messina, Italy. E-mail: tuccari@unime.it
How to cite this article: Ieni A, Angelico G, De Sarro R, Fleres F, Macrì A, Tuccari G. Uterine large cell neuroendocrine carcinoma with unusual
colonic metastasis. J Cancer Metastasis Treat 2017;3:144-9.
ABSTRACT
Article history: A 78-year-old female patient arrived at our practice complaining of progressive abdominal
Received: 27-02-2017 increase and presenting a clinical picture of intestinal obstruction. At physical examination,
Accepted: 23-05-2017 the abdomen appeared distended, moderately painful with the presence of a mass of hard
Published: 16-08-2017 consistency. Abdominal computed tomography scan showed a large hypodense pelvic mass
that indicated a compression and lateral deviation of the uterus and bladder. Microscopically,
Key words: the mass showed a uniform solid pattern, composed of medium and large-sized cells with
Neuroendocrine carcinoma, hyperchromatic and pleomorphic nuclei demonstrating high mitotic activity and diffuse
metastasis, immunoreactivity for estrogen receptors and synaptophysin. A diagnosis of uterine poorly
uterus, differentiated large cell neuroendocrine carcinoma, arising in the endometrium with an
differential diagnosis, unusual colonic metastatic localization, was made.
immunohistochemistry

INTRODUCTION unknown primary NETs has not been fully determined.
[4]
To identify the nature as well as the primary site of
Uterine neuroendocrine carcinomas are rare and NETs, the immunohistochemical approach appears
highly malignant tumors, morphologically subdivided to be the most useful approach. It allows a correct
into small and large cell according to their nuclear characterization identifying site-specific transcription
size, presenting as pure or combined forms, either factors, such as thyroid transcription factor 1 (TTF-1)
associated with endometrioid adenocarcinoma or and CDX2. In particular, nuclear TTF-1 staining is
[5]
as a component of a malignant mixed müllerian effective in more than 50% of pulmonary carcinoids
tumor. [1,2] It has been reported that the primary site of but only rarely in gastrointestinal NETs, while nuclear
neuroendocrine tumors (NETs) is unknown in about CDX2-staining is revealed in gastrointestinal NETs
13% of patients, although the exact incidence of but seldom in pulmonary carcinoids. Moreover, in
[5]
[3]
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