Endocrine Abstracts

Introduction: Neuroendocrine Tumors of the Colon are often aggressive and metastatic at diagnosis. The diagnosis is histologicaly obtained through immunohistochemical evaluation of biopsy specimens/metastases, with positive staining for Chromogranin A and Synaptophysin.

Case Report: A 54-year-old independent patient with Type 1 Diabetes, leading to diabetic nephropathy, underwent a renal transplant followed by graft failure and is currently on hemodialysis and systemic corticosteroid therapy. She presented to the Emergency with abdominal pain, described as constant, squeezing, located in the left flank, refractory to analgesia, associated with unintentional weight loss of 1.5 kg, night sweats, and constipation, all during the last month. Imaging studies revealed a lombo-aortic and mesenteric lymph node conglomerate, leading to hospitalization for further evaluation and symptomatic control. During the hospitalization, additional studies showed presence of an ulcerative and vegetative tumor in the descending colon, measuring 3 cm in length. Biopsy results were consistent with poorly differentiated colon carcinoma (CK20+/CK7/CDX2+), with neuroendocrine differentiation. Additional CT-CTAP imaging revealed the presence of supra and infra-diaphragmatic conglomerates. A diagnosis of metastatic Neuroendocrine Tumor of the Colon was made, and immunotherapy with Ipilimumab and Nivolumab was proposed. The patient is currently awaiting the first cycle of treatment.

Conclusion: This case report aims to demonstrate not only the importance of reviewing rare tumors, particularly neuroendocrine tumors, but also to highlight their nonspecificity and aggressiveness.