Gastroenterologie up2date 2016; 12(01): 16-18
DOI: 10.1055/s-0042-100860
Klinisch-pathologische Konferenz
© Georg Thieme Verlag KG Stuttgart · New York

Neuroendokrines Karzinom des Analkanals: Eine seltene Differenzialdiagnose

Dirk Graf
Further Information

Publication History

Publication Date:
18 March 2016 (online)

Fazit

Der demonstrierte Fall einer Patientin mit inguinal metastasiertem NEC des Analkanals spiegelt ein individualisiertes adjuvantes Therapieschema für die seltene Entität eines NEC des Analkanals wider. Auch wenn keine durch prospektive Studien gesicherten Empfehlungen zur adjuvanten Therapie bei GEP-NEC vorliegen, sprachen der Nachweis einer inguinalen Metastasierung mit Tumorthrombus in der V. femoralis und der mikroskopische Nachweis von Tumorzellen in den inguinalen Resektionsrändern bei hochproliferativem NEC für die Durchführung einer adjuvanten Therapie. Diese bestand aus einer Kombinationschemotherapie mit Cisplatin und Etoposid sowie einer lokalen Radiotherapie der Leistenregion. Dieses individualisierte Vorgehen führte dazu, dass die Patientin 8 Monate nach Operation lebt.

 
  • Literatur

  • 1 Niederle MB, Hackl M, Kaserer K et al. Gastroenteropancreatic neuroendocrine tumours: the current incidence and staging based on the WHO and European Neuroendocrine Tumour Society classification: an analysis based on prospectively collected parameters. Endocr Relat Cancer 2010; 17: 909-918
  • 2 Yao JC, Hassan M, Phan A et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008; 26: 3063-3072
  • 3 Pape UF, Berndt U, Muller-Nordhorn J et al. Prognostic factors of long-term outcome in gastroenteropancreatic neuroendocrine tumours. Endocr Relat Cancer 2008; 15: 1083-1097
  • 4 Garcia-Carbonero R, Capdevila J, Crespo-Herrero G et al. Incidence, patterns of care and prognostic factors for outcome of gastroenteropancreatic neuroendocrine tumors (GEP-NETs): results from the National Cancer Registry of Spain (RGETNE). Ann Oncol 2010; 21: 1794-1803
  • 5 Caplin M, Sundin A, Nillson O et al. ENETS Consensus Guidelines for the management of patients with digestive neuroendocrine neoplasms: colorectal neuroendocrine neoplasms. Neuroendocrinology 2012; 95: 88-97
  • 6 Kolby L, Bernhardt P, Sward C et al. Chromogranin A as a determinant of midgut carcinoid tumour volume. Regul Pept 2004; 120: 269-273
  • 7 Ardill JE, Erikkson B. The importance of the measurement of circulating markers in patients with neuroendocrine tumours of the pancreas and gut. Endocr Relat Cancer 2003; 10: 459-462
  • 8 O’Toole D, Grossman A, Gross D et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: biochemical markers. Neuroendocrinology 2009; 90: 194-202
  • 9 Han X, Zhang C, Tang M et al. The value of serum chromogranin A as a predictor of tumor burden, therapeutic response, and nomogram-based survival in well-moderate nonfunctional pancreatic neuroendocrine tumors with liver metastases. Eur J Gastroenterol Hepatol 2015; 27: 527-535
  • 10 Pavel M, Baudin E, Couvelard A et al. ENETS Consensus Guidelines for the management of patients with liver and other distant metastases from neuroendocrine neoplasms of foregut, midgut, hindgut, and unknown primary. Neuroendocrinology 2012; 95: 157-176
  • 11 Kunz PL, Reidy-Lagunes D, Anthony LB et al. Consensus guidelines for the management and treatment of neuroendocrine tumors. Pancreas 2013; 42: 557-577
  • 12 Eriksson B, Annibale B, Bajetta E et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: chemotherapy in patients with neuroendocrine tumors. Neuroendocrinology 2009; 90: 214-219
  • 13 Welin S, Sorbye H, Sebjornsen S et al. Clinical effect of temozolomide-based chemotherapy in poorly differentiated endocrine carcinoma after progression on first-line chemotherapy. Cancer 2011; 117: 4617-4622
  • 14 Bajetta E, Catena L, Procopio G et al. Are capecitabine and oxaliplatin (XELOX) suitable treatments for progressing low-grade and high-grade neuroendocrine tumours?. Cancer Chemother Pharmacol 2007; 59: 637-642
  • 15 Hadoux J, Malka D, Planchard D et al. Post-first-line FOLFOX chemotherapy for grade 3 neuroendocrine carcinoma. Endocr Relat Cancer 2015; 22: 289-298
  • 16 Okita NT, Kato K, Takahari D et al. Neuroendocrine tumors of the stomach: chemotherapy with cisplatin plus irinotecan is effective for gastric poorly-differentiated neuroendocrine carcinoma. Gastric Cancer 2011; 14: 161-165