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Gastrointestinal Cancers • Medical Oncology • Neuroendocrine Tumors • NCI-CCC Tumor Board Question • Rutgers • NCI-CCC GI Tumor Board Question • NCI-CCC Neuroendocrine Tumor Board
How would you approach adjuvant therapy for a patient with resected T4N1 high grade large cell neuroendocrine tumor of the cecum with adenocarcinoma component?
Pathology details: 75% high grade large cell neuroendocrine tumor of the cecum (20-30 mitoses per 10 hpf, Ki67 75%) and 25% adenocarcinoma. Patient has V600E mutation and is also MSI-H (loss of MLH1, PMS2). Stage pT4N1M0 (neuroendocrine staging).
Answer from: Medical Oncologist at Community Practice
However the diagnosis of mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) requires that each component (NEC and adenocarcinoma) exceeds 30%, I will make sure with pathology again this case is not MiNEN. For most patients with apparently localized GEP NECs, or MiNEN we should proceed with adj...
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