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A complex case of rectal neuroendocrine carcinoma with terminal delirium
1Department of Radiotherapy and Medical Oncology, The Norwegian Radium Hospital, Norway. a.h.ree@medisin.uio.no
Background:
A 62-year-old white male presented to our department in December 2004 with a 1-month history of intermittent, voluminous bleedings per rectum. His medical history was unremarkable apart from a single, short-lasting syncope shortly before the first bleeding episode.
Investigations:
Physical examination, colonoscopy, rectal tumor biopsy and immunohistochemistry, pelvic MRI, abdominal and chest CT scans, ultrasound-directed puncture cytology, octreotide scintigraphy, biochemical analysis of tumor markers, and conventional laboratory tests.
Diagnosis:
Locally advanced rectal neuroendocrine carcinoma with liver metastases.
Management:
Chemotherapy, CT-planned radiotherapy, antihypercalcemic therapy, terminal supportive care.