Cecal Adenoendocrine Cell Carcinoma Presented with Right Inguinal Lymph Node Metastasis Yields Complete Response to mFOLFOX6 and Bevacizumab:A Case Report

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A 58-year-old man was referred to our hospital because of right lower abdominal pain. Colonoscopy and PET-CT revealed an advanced cancer of the cecum with right inguinal lymph node metastasis. Biopsy showed poorly differentiated adenocarcinoma with neuroendocrine differentiation. Immunostaining for Ki-67, CD56 and Chromogranin A were positive. Systemic chemotherapy using six cycles of mFOLFOX6 combined with bevacizumab resulted in reduction of the inguinal lymphadenopathy. Laparoscopic ileocecal resection with right inguinal lymph node dissection was then performed. Pathological complete response (pCR) was confirmed by histopathological examination. This patient is alive without recurrence 18 months after surgery.<BR>Neuroendocrine cell carcinoma of the colon is rare and its prognosis is poor. Inguinal lymph node metastasis from the colon is another poor prognostic factor. This patient had a remarkably good response to a general therapeutic chemotherapy regimen for colorectal carcinoma, followed by sequential radical surgery. In conclusion, multitherapeutic modalities should be considered for patients with neuroendocrine cell carcinoma in need of a drastic effect and cure.