{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T19:41:54Z","timestamp":1777232514684,"version":"3.51.4"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin J Gastroenterol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Neuroendocrine tumors are rare malignancies comprising neuroendocrine cells widely distributed in the human body. They occur in various organs of the body, most commonly in the gastrointestinal tract and pancreas in the Japanese population. Mixed neuroendocrine\u2013non-neuroendocrine neoplasm is included in the 2019 WHO classification and defined as having more than 30% of both neuroendocrine and non-neuroendocrine tumor components. However, the number of reports on mixed neuroendocrine and non-neuroendocrine tumors is particularly small. Herein, we encountered a rare case of a tiny neuroendocrine carcinoma in a large flat-elevated rectal tumor resulting in rapid multiple liver metastases. This case was referred to our institution for endoscopic submucosal dissection. Histopathological analysis showed that tubular adenocarcinoma and adenoma were the predominant lesions. Moreover, the neuroendocrine carcinoma component was less than 3% of the total tumor, measuring approximately 5\u00a0mm. However, the neuroendocrine carcinoma component was found to be the most advanced part of the infiltrate (T1b at least; SM3.8\u00a0mm). Repeat computed tomography 1 week after endoscopic submucosal dissection for evaluating intraoperative perforation revealed liver metastasis, and chemotherapy is currently underway.<\/jats:p>","DOI":"10.1007\/s12328-022-01691-9","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T07:04:43Z","timestamp":1661929483000},"page":"1078-1082","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A case of a tiny neuroendocrine carcinoma in a large flat-elevated rectal tumor causing multiple liver metastases"],"prefix":"10.1007","volume":"15","author":[{"given":"Daisuke","family":"Ohki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9537-4993","authenticated-orcid":false,"given":"Yosuke","family":"Tsuji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariko","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuo","family":"Ushiku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuhiro","family":"Fujishiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,31]]},"reference":[{"key":"1691_CR1","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/his.13975","volume":"76","author":"ID Nagtegaal","year":"2020","unstructured":"Nagtegaal ID, Odze RD, Klimstra D, et al. 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Neuroendocrinology. 2016;103:186\u201394.","journal-title":"Neuroendocrinology"},{"key":"1691_CR6","doi-asserted-by":"publisher","first-page":"1992","DOI":"10.1007\/s00464-008-0006-x","volume":"22","author":"BN Kim","year":"2008","unstructured":"Kim BN, Sohn DK, Hong CW, et al. Atypical endoscopic features can be associated with metastasis in rectal carcinoid tumors. Surg Endosc. 2008;22:1992\u20136.","journal-title":"Surg Endosc"},{"key":"1691_CR7","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1159\/000478743","volume":"105","author":"T Tanaka","year":"2017","unstructured":"Tanaka T, Kaneko M, Nozawa H, et al. Diagnosis, assessment, and therapeutic strategy for colorectal mixed adenoneuroendocrine carcinoma. 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Endocr Pathol. 2022;33:115\u201354.","journal-title":"Endocr Pathol"}],"container-title":["Clinical Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12328-022-01691-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12328-022-01691-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12328-022-01691-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T18:30:16Z","timestamp":1669401016000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12328-022-01691-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,31]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["1691"],"URL":"https:\/\/doi.org\/10.1007\/s12328-022-01691-9","relation":{},"ISSN":["1865-7257","1865-7265"],"issn-type":[{"value":"1865-7257","type":"print"},{"value":"1865-7265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,31]]},"assertion":[{"value":"7 June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All methods were performed in accordance with the relevant guidelines and regulations including the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human rights"}},{"value":"Informed consent was obtained from the patient to be included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}