Neuro Cancer

Neuro cancer is a malignant tumor that occurs in the neuroendocrine system and belongs to the oncology department. Its pathological types include large cell neuroendocrine carcinoma, carcinoid carcinoma, atypical carcinoid carcinoma, and small cell carcinoma. Among them, the metastasis and recurrence rate of carcinoid carcinoma is low, while the malignancy of small cell carcinoma is high. It should be noted that tumors that occur in the nervous system and do not involve endocrine function are usually referred to as neuromas rather than neurocancers.

Figure 1. Neuro Cancer.

Diagnosis

Diagnosis should be combined with endoscopic examination and pathological analysis, and immunohistochemical markers NSE, CgA, and Syn can assist in differentiation. The treatment is mainly surgical, and local resection or radical surgery is selected based on the tumor diameter, depth of invasion, and metastasis. Tumors with a diameter less than 2 centimeters and no metastasis have a better prognosis, while those with a diameter less than 2 centimeters require chemotherapy and biological therapy. In daily diet, vegetables and fruits may reduce the risk of disease due to their high content of dietary fiber and vitamins, while N-nitroso compounds in pickled foods are potential risk factors.

Prognosis

Gastrointestinal carcinoid tumors generally have a better prognosis than adenocarcinoma. Tumors with a diameter less than 2 cm have a similar prognosis to benign tumors, while those with a diameter greater than 2 cm or lymph node metastasis have a poorer prognosis; The prognosis of multifocal or mixed cancer and small cell neuroendocrine carcinoma is worse. Attention should be paid to postoperative follow-up of this disease. For cases with high malignancy, regular liver ultrasound, CT scans, and dynamic monitoring of the concentration of biogenic amines and peptides metabolites in urine should be conducted during follow-up. Chemotherapy, biological therapy, and other comprehensive treatment measures should be selectively supplemented to improve survival rate.

Treatment Options

The treatment of gastrointestinal neuroendocrine carcinoma mainly relies on surgery, and the scope of surgery depends on the size, location, degree of invasion, lymph node involvement, and liver metastasis of the primary tumor. During the operation, it is necessary to carefully investigate whether there are multiple lesions or coexisting other tumors. According to the literature on the biological characteristics of gastrointestinal neuroendocrine carcinoma, it is generally believed that the principle of surgical treatment is: local resection can be performed for gastric, appendiceal, and rectal cancers with a tumor diameter less than 2 cm, no involvement in the muscle layer, and no lymph node metastasis; Radical surgery is required for small intestine and colon carcinoid tumors or tumors larger than 2 cm, infiltrating the muscular layer, and with lymph node metastasis; For metastatic carcinoid tumors, if the overall condition allows, palliative resection of the primary and metastatic lesions can be performed. On the basis of the above principles, different surgical methods are adopted for gastrointestinal cancer. The resection range for multifocal and mixed carcinoid tumors, as well as small cell neuroendocrine carcinoma, should be appropriately expanded, and the surgical method should be the same as that for gastrointestinal adenocarcinoma.