Rectal Small Cell Carcinoma: A Case Report and Review of the Literature

Abstract

We present a rare case of small cell carcinoma of the rectum presenting with rectal bleeding and discomfort in a fit 51-year-old gentleman. Our patient was treated with a combination of chemotherapy and radiotherapy and remains alive and free of disease 6 years after diagnosis. Our patient experience and review of the literature is presented highlighting the uncertainties regarding the biological behaviour and management.

Metachronous presentation of small-cell rectal carcinoma on an 18F-FDG PET/CT follow-up for follicular lymphoma

“…Neuroendocrine tumors of the GI tract often present with metastatic disease and thus generally carry a poor prognosis [7] . Prior case reports have shown that the disease is invariably fatal, and therapy is complex due to the rarity and limited reports describing effective treatment of these tumors [1] . In addition, many of these tumors have been found to have components of squamous cell carcinoma and adenocarcinoma, which further complicate treatment [2] .…”

“…Small-cell carcinoma of the rectum is a rare, aggressive neoplasm derived from neuroendocrine cells within the gastrointestinal (GI) tract [1] , [2] . Very few case reports of small-cell rectal carcinoma have been published, and available therapies are generally not very effective, with the disease generally carrying a poor prognosis [1] . We describe an unusual case of metachronous small-cell rectal carcinoma presenting on an 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) follow-up for follicular lymphoma.…”

Neuroendocrine small cell rectal cancer metastasizing to the liver: a unique treatment strategy, case report, and review of the literature

“…Spiliopoulou et al . [7] reported a case in 2011 of a patient with an obstructing tumor in the lower rectum (limited disease) treated with a combination of chemotherapy and radiotherapy; this patient was disease-free 4.5 years after completion of the treatment. In 2004, Kim et al .…”

“…Staging [7] and management [5] of GI tract SCC have been proposed and implemented in case reports and a few retrospective studies. The staging system was introduced by the Veteran’s Administrating Lung Study Group (VALSG) for primary SCC of the lung [8].…”

“…According to this system, SCC can be divided into two categories: 1) limited disease, in which the tumor is contained within a localized region; and 2) extensive disease, in which the tumor is outside the locoregional boundaries. The treatment for limited disease is local treatment in the form of radiotherapy, surgery, or both, plus platinum-based chemotherapy [7,9,10]. Distant metastasis (extensive disease) is treated with platinum-based combination chemotherapy [9,11].…”