Neuroendocrine metastasic carcinoma of undetermined origin: Case report

Abstract

Background: The neuroendocrine tumors (NETs) are originate from cells that release hormones into the circulation in response to signals from the nervous system. They are classified into three categories according to their degree of differentiation and mitotic index: those known as neuroendocrine carcinoma (NEC) are characterized by being poorly differentiated and having a high rate of mitosis. Objective: To show the factors that influence the prognosis of the disease and the difficulty in identifying the origin of the primary tumor according to the stage of the disease. Case presentation: A 83-year-old male patient with a history of chronic noncommunicable diseases of type 2 diabetes and systemic arterial hypertension. He was admitted for oppressive abdominal pain in the right hypochondrium radiating to the right iliac fossa and lumbar region, as well as weight loss of 25 kg in 3 months. Methods: Abdominal tomography with double contrast identified multiple adenopathies in conglomerates in retroperitoneum predominantly for aortic and mesentery root. Colonoscopy and endoscopy without relevant findings. Biopsy reported undifferentiated small cell carcinoma, immunohistochemistry identified immunophenotype of metastatic neuroendocrine carcinoma of non-pulmonary origin. He was followed up by oncology who indicated palliative care due to the prognosis of the disease. The patient passed away two months later due to complications of the disease. Conclusion: The NEC has a poor prognosis due to its high malignancy. Up to 50% present metastases at the time of diagnosis, with a survival rate of 5.8 months. Due to the late diagnosis of the disease some are classified as NETs of unknown primary origin despite the multiple markers available for its identification.

Recepción: 08/01/2025

Aprobación: 28/02/2025