동시성의 작은 직장 신경내분비종양에 동반된 간 전이 1예
Liver Metastasis of Synchronous Small Rectal Neuroendocrine Tumors in the Absence of Risk Factors
김선아, 최지은, 김병창, 장희진, 손대경,
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김선아 ( Kim Seon-A )
국립암센터 소화기내과
최지은 ( Choi Jee-Eun )
국립암센터 소화기내과
김병창 ( Kim Byung-Chang )
국립암센터 소화기내과
장희진 ( Chang Hee-Jin )
국립암센터 대장암센터
손대경 ( Sohn Dae-Kyung )
국립암센터 대장암센터
Abstract
The incidence of rectal neuroendocrine tumors (NETs) has increased worldwide, including in Korea. Rectal NETs are usually single lesions, but synchronous multiple lesions are reported in 2-4.5% of patients. Small rectal NETs (≤ 10 mm) are usually confined to the submucosal layer and rarely give rise to lymph node or distant metastases. Here we describe the case of a 54-year-old woman referred to National Cancer Center for the management of two rectal subepithelial tumors. Because computed tomography revealed a small hepatic nodule suggesting atypical hemangioma rather than metastasis, endoscopic submucosal dissection was performed. However, the size of the nodules increased during follow-up. The pathologic results of a liver biopsy confirmed metastatic NET. This case was unusual in that synchronous small rectal NETs and distant liver metastasis occurred in the absence of any risk factors for metastasis. Thus, patients with rectal NETs should be carefully evaluated, especially for the possibility of metastasis.
키워드
Rectum; Neuroendocrine tumor; Liver; Neoplasm metastasis
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