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Rectal Neuroendocrine Tumor with Multiple Liver Metastasis with Recurrence after Endoscopic Submucosal Dissection, Report of a Case Kenjiro Suzuki 1 , Dai Hirasawa 1 , Naotaka Fujita 1 , Yutaka Noda 1 , Takashi Obana 1 , Toshiki Sugawara 1 , Tetsuya Ohira 1 , Yoshihiro Harada 1 , Yuki Maeda 1 , Yoshiki Koike 1 , Taku Yamagata 1 , Jun Kusaka 1 , Megumi Tanaka 1 1Department of Gastroenterology, Sendai City Medical Center, Sendai Open Hospital, Sendai, Japan Keyword: 直腸NET , ESD , Ki-67 L.I. , WHO分類 , 転移予測因子 pp.1037-1041
Published Date 2013/6/25
DOI https://doi.org/10.11477/mf.1403113862
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 A 49-year-old woman with positive results on a fecal occult-blood test for colorectal cancer screening underwent total colonoscopy in a nearby hospital, which revealed a submucosal tumor in the distal rectum. The yellowish white tumor was 11mm in diameter and was subsessile with a depression at its top. Based on the diagnosis of NET(neuroendocrine tumor)revealed by a biopsy at the previous hospital, ESD(endoscopic submucosal dissection)was carried out. Histological examination of the resected specimen showed that the depth of invasion was sm, without lymphovascular invasion. The tumor was completely excised with clear margins. Mitosis was minimal and Ki-67 L.I. was high at 5.2%. Surveilance CT examination, performed every year after ESD, detected multiple liver metastasis two years and eight months later. The patient died after six years and eight months in spite of additional treatment. Ki-67 has been included in the WHO grading system of NET since 2010, and further elucidation of its significance as a predictive factor of metastasis is expected.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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