Long-term survival after multimodality treatment of metastatic mixed adenoneuroendocrine carcinoma of colon: A case report

Figure 1 Hematoxylin and eosin and immunohistochemistry staining of ascending colon and liver metastasis. A: Hematoxylin and eosin (HE) staining of mixed adenoneuroendocrine carcinoma (MANEC) of ascending colon; B: Immunohistochemistry (IHC) staining of ascending colon showed Syn (++); C: IHC staining of ascending colon showed CgA (+); D: IHC staining of ascending colon showed Ki67 (90%+); E: HE staining of MANEC of liver metastasis; F: IHC staining of liver metastasis showed Syn (++); G: IHC staining of liver metastasis showed CgA (+); H: IHC staining of liver metastasis showed Ki67 (90%+) ( × 100). HE: Hematoxylin and eosin; Syn: Synaptophysin; CgA: Chromogranin.

Figure 2 Abdominal computed tomography and magnetic resonance during the treatment and follow-up. A: On October 8, 2014, a nodular lesion was found in the segment VI of the liver; B: On February 29, 2016, punctate and small nodular abnormal signals were found in both the lobes of the liver; C: On May 28, 2016, the size of the original punctate and small nodular abnormal signals in the liver had increased; D: On October 15, 2016, a new lesion in the segment VI of the liver was found; E: On June 14, 2017, several new nodules were found in the right lobe of the liver; F: On August 17, 2020, reexamination showed no new lesions in the liver; G: On September 23, 2022, reexamination showed no new lesions in the liver; H: On July 19, 2024, reexamination showed no new lesions in the liver. Orange arrows indicate the main lesions.

Figure 3 Timeline of the patient’s treatment and clinical course. PD: Progressive disease; CR: Complete response; OS: Overall survival; PFS: Progression free survival.