Colorectal glandular-neuroendocrine mixed tumor: pathologic spectrum and clinical implications.

摘要: Colorectal glandular-neuroendocrine mixed tumor is an uncommon entity with ill-defined clinicopathologic characteristics. We describe the clinicopathology of 23 new cases and review 67 previously reported cases. Clinically, patients (mean age, 61.9 y; male: female, 1.0:1.1) presented a positive fecal occult blood test or visible rectal bleeding (44%), abdominal pain change in bowel movement pattern (25%), obstruction (19%), weight loss (19%). Endoscopically, tumors as polypoid lesion (57%), mass (30%), ulcerating (9%). Tumors were located right colon (56%), transverse (3%), left (41%). Surgical resection was treatment choice 83% After follow-up for average 20 months, tumor-related death rate 68%. Histologically, 42% classified composite 58% collision tumors. An adenoma to carcinoma, then carcinoma progression through APC/β-catenin pathway seen majority Both glandular neuroendocrine components can show spectrum differentiation, each component metastasize separately regardless its percentage volume. On basis combined analysis pathologic clinical behavior our series cases, we propose classification system that reflects differentiation colorectal facilitate uniform reporting better predict behavior.