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Pathological Complete Response in a Rare Case of Rectal Small Cell Neuroendocrine Carcinoma Following Neoadjuvant
Abhisek Jha1, Vivek Ghosh1, Samit Gautam1
1Department of Clinical Oncology Birat Medical College and Teaching Hospital Morang Nepal.
Clinical Case Reports
|November 14, 2025
Summary
Rectal neuroendocrine neoplasms are rare but aggressive. This case shows neoadjuvant radiochemotherapy followed by surgery achieved a complete response in a high-grade rectal neuroendocrine carcinoma patient.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Rectal neuroendocrine neoplasms (NENs) are uncommon, aggressive malignancies.
- Small cell neuroendocrine carcinoma (SCNEC) is a high-grade variant with poor prognosis.
- Increasing incidence due to improved endoscopic detection.
Purpose of the Study:
- To report a case of poorly differentiated SCNEC.
- To highlight diagnostic and therapeutic challenges.
- To evaluate neoadjuvant radiochemotherapy efficacy.
Main Methods:
- Case report of a 32-year-old male with rectal bleeding.
- Diagnosis confirmed by histopathology and immunohistochemistry.
- Treatment included neoadjuvant radiochemotherapy and abdominoperineal resection.
Main Results:
- Histopathology confirmed poorly differentiated SCNEC (Grade 3).
- Patient achieved pathological complete response after neoadjuvant therapy and surgery.
- High Ki-67 index and neuroendocrine marker expression noted.
Conclusions:
- Immunohistochemistry is crucial for diagnosing rectal NENs.
- Neoadjuvant radiochemotherapy may improve outcomes in SCNEC.
- Early diagnosis and multidisciplinary management are key for favorable prognosis.
