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Case Reports
. 2002 Sep;55(9):710-4.
doi: 10.1136/jcp.55.9.710.

A tumour with a neuroendocrine and papillary serous component: two or a pair?

S Van Eeden  1 , P M Nederlof, B G Taal, G J A Offerhaus, M-L F Van Velthuysen
Affiliations
Case Reports

A tumour with a neuroendocrine and papillary serous component: two or a pair?

S Van Eeden et al. J Clin Pathol. 2002 Sep.

Abstract

Aims: To examine the clonal origin of a tumour, made up of a neuroendocrine component and a papillary serous component by comparing the pattern of loss of heterozygosity (LOH) and the immunohistochemical protein expression of both components.

Methods/results: A 70 year old woman, known to have a metastasised neuroendocrine carcinoma, underwent resection of the distal part of the ileum because of obstruction by a mesenterial mass. The macroscopically homogeneous mesenterial mass consisted histologically of an admixture of a neuroendocrine component and a papillary serous carcinoma. Loss of heterozygosity (LOH) analysis of both components with a panel of 15 polymorphic microsatellite markers showed a distinctive pattern of LOH, and both components showed LOH on chromosome 4q and 17, but involving different alleles at the same locus. Moreover, both components showed different immunohistochemical staining patterns for neuroendocrine markers, cytokeratin 7, carcinoembryonic antigen, and CA125.

Conclusion: Both LOH analysis of the neuroendocrine and papillary serous components of this tumour and the immunohistochemical profile of both components are consistent with a different clonal origin. The tumour is probably a collision tumour, in which the papillary serous carcinoma must have been of peritoneal origin because necropsy revealed a normal uterus and normal ovaries.

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Figures

Figure 1
Figure 1
(A) Mucinous adenocarcinoma of the colon, diagnosed 18 years before the current medical history. (B) Low grade neuroendocrine carcinoma. (C) Papillary serous carcinoma in the mesentery of the resected ileum. (D) Collision of the papillary serous and neuroendocrine component in the mesentery of the resected ileum.
Figure 2
Figure 2
The allelic imbalance of the various microsatellite markers used for the loss of heterozygosity (LOH) analysis of the two tumours. LOH is seen at markers D4S430 (chromosomal arm 4q) and D17S588 (chromosome 17) in both tumours, but involving different alleles (indicative of a distinct origin of the two tumours). Diamond shapes, tumour 1 (neuroendocrine carcinoma); squares, tumour 2 (papillary serous adenocarcinoma). NR, normal ratio; TR, tumour ratio.
See this image and copyright information in PMC

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