An unusual case of neuroendocrine tumor

Abstract

Abstract Introduction: Neuroendocrine tumour is defined as tumour arising in specialised cells called neuroendocrine cells who show traits of nerve cells and hormone producing cells. These slow growing tumours are more common in adult female than in males or children and often present with vague symptoms. This report highlights unusual case of NET diagnosed incidentally intraoperatively. Clinical Case: A 46 yrs. old P2L2, menstruating women was referred with complaints of mild lower abdomen pain for 3 months. Since patient was symptomatic and USG inconclusive, MRI pelvis was done which revealed a well marginated thin-walled lesion in left paracentral presacral area suggestive of Para-ovarian or Haemorrhagic cyst. Patient posted for laparoscopy in view of adnexal cyst and intraoperative findings revealed normal uterus, bilateral tubes, and ovaries with no evidence of para-ovarian cyst. On examining lateral pelvic wall, a paracentral mass lateral to left uterosacral ligament was noted, excised, and retrieved in toto. Histopathology and immunohistochemical analysis suggestive of well differentiated Neuroendocrine tumour of WHO GRADE 2. Primary was noted in anterolateral wall of mid-rectum and colonoscopic biopsy confirmed the diagnosis followed by which low anterior resection of rectum was performed. Patient was followed for postoperative recovery and discharged. Conclusion: According to literature there is often a delay of average 52 months before patient reaches its correct diagnosis. High index of suspicion remains a key to clench diagnosis in such cases.