Mixed adenoneuroendocrine carcinoma of the gastrointestinal tract-features, diagnosis, management and prognostics

摘要

Immunohistochemical studies of gastrointestinal tumours have identified a broad spectrum of combinations between exocrine and neuroendocrine components. The wide range of this type of neoplasia varies from adenomas or adenocarcinomas with scattering neuroendocrine cells to classic neuroendocrine tumours with focally disposed of exocrine elements. Both the exocrine and endocrine elements may have different morphopathological features. The exocrine segment may be an adenoma or even adenocarcinoma with various degrees of differentiation, and the neuroendocrine fraction can be poorly or well differentiated. The mixed adenoneuroendocrine carcinomas group (MANECs) include those carcinomas in which both neuroendocrine and exocrine components represent at least 30% of the entire tumoral mass. The number of cases mentioned in the literature is small due to the low incidence of this type of pathology, but it can affect any segment of the gastrointestinal tract and depend on the degree of malignancy of each component and its localisation, patients were classified in different prognostic categories. The current review presents a synthesis of morphopathological, immunohistochemical, molecular and genetic characteristics, clinical-imaging diagnostic elements, management and prognosis specific to this type of cancer.