Mixed Neuroendocrine-NonNeuroendocrine Neoplasm of the Sigmoid colon: the first case reported in Perú

Manuel Moreno Gonzales; Paul Pilco Castañeda; Juan Chirinos Vega; Jaime Montes Gil; Luana Mesones Duffoó; Giulia Corigliano Mazzi; Aranza Pujazón Madueño; Nelson Cuevas Muñoz

doi:10.47892/rgp.2026.462.2100

Autores/as

Manuel Moreno Gonzales Clínica Anglo Americana, Lima, Perú. https://orcid.org/0000-0001-8518-1848
Paul Pilco Castañeda Clínica Anglo Americana, Lima, Perú. https://orcid.org/0009-0000-4917-0383
Juan Chirinos Vega Clínica Anglo Americana, Lima, Perú. https://orcid.org/0000-0003-4409-6238
Jaime Montes Gil Clínica Anglo Americana, Lima, Perú. https://orcid.org/0000-0003-3980-4199
Luana Mesones Duffoó Clínica Anglo Americana, Lima, Perú. https://orcid.org/0000-0003-0250-6518
Giulia Corigliano Mazzi Clínica Anglo Americana, Lima, Perú. https://orcid.org/0000-0003-2402-0869
Aranza Pujazón Madueño Clínica Anglo Americana, Lima, Perú. https://orcid.org/0000-0001-9415-4278
Nelson Cuevas Muñoz Clínica Anglo Americana, Lima, Perú. https://orcid.org/0000-0002-1184-6162

DOI:

https://doi.org/10.47892/rgp.2026.462.2100

Palabras clave:

Neoplasms, Complex and Mixed, Neuroendocrine Tumors, Immunohistochemistry

Resumen

Mixed Neuroendocrine-NonNeuroendocrine Neoplasms (MiNENs) are rare and aggressive entities, with scarce reports worldwide, especially from Latin America. We describe the first documented case of sigmoid MiNEN in Perú in a 77-year-old woman with a history of hypertension, diabetes, and osteoporosis who presented with left lower quadrant pain and abdominal distension. Colonoscopy revealed polyps, one of which was histologically consistent with a large-cell neuroendocrine carcinoma (NEC) and a high-grade tubular adenoma, each accounting for ≥30% of the lesion, fulfilling MiNEN criteria. Immunohistochemistry confirmed the diagnosis with an Antigen Kiel 67 [Ki-67] index of 70%. Positron Emission Computed Tomography (PET/CT) demonstrated focal uptake without nodal involvement. The patient underwent laparoscopic radical sigmoidectomy with colorectal anastomosis; histopathology confirmed submucosal invasion and metastasis in 5/14 lymph nodes. She was subsequently started on adjuvant carboplatin/etoposide chemotherapy and remains under oncological follow-up. This case underscores the diagnostic and therapeutic challenges of colorectal MiNENs, highlights the role of PET/CT as well as multidisciplinary management, and emphasizes the importance of considering radical resection even after endoscopic removal, given the high risk of recurrence and aggressive biological behavior.

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