The dedifferentiation of neuroendocrine tumor metastases: myth or reality?

Vol. 54 No. 1, 2013

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Catalina Poiana, M. C. Neamtu, Elena Taina Avramescu, Mara Carsote, Raluca Trifanescu, Dana Terzea, Oana Maria Neamtu, Rucsandra Danciulescu Miulescu

Dedifferentiation is a process that may be found in metastasis from the neuroendocrine tumors. We present the case of a female within the seventh decade of life incidentally diagnosed with a mature teratoma with element of cartilages, bronchia, mucinous glands, and a poorly differentiated neuroendocrine carcinoma (Ki67 of 30%). After six months of chemotherapy and another six months of disease free interval, a metastasis of the great omentum was removed. The dedifferentiation was diagnosed based on much higher Ki67 (of 70%). The loss of estrogen receptor of 40% from the initial site to 3% into metastasis indicates an exclusive neuroendocrine aggressive pattern. The ovarian carcinoid is a rare situation, and metastasis to the great omentum with dedifferentiation is even seldom.

Corresponding author: Raluca Trifanescu, MD; e-mail: ralucatrifanescu@yahoo.com

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