[Neuroendocrine carcinoma of the colon with metastasis to the brain: a case report and review of the literature]. / Carcinoma neuroendocrino del colon con metastasi cerebrale. Descrizione di un caso e revisione della letteratura.

The Authors report a case of a 71-year-old male with synchronous neuroendocrine colon carcinoma and a solitary brain metastasis. The patient was treated surgically with resection of both the cerebral and intestinal lesions followed by cerebral radiotherapy. A pulmonary metastasis was discovered after 3 months and treated with interferon and octreotide. No further cerebral or intestinal relapses were observed. The patient died of cardiac disease 11 months after the first operation. Central nervous system metastases from carcinoid tumours are rare. The reported survival in untreated cases or in cases treated by radiotherapy alone is 4 months. In the case reported, surgical resection of the cerebral and intestinal lesions followed by intracranial radiotherapy yielded complete local control of the disease and a slight improvement in survival.

Linking estrogen receptor ß expression with inflammatory bowel disease activity.

Crohn disease (CD) and ulcerative colitis (UC) are chronic forms of inflammatory bowel disease (IBD) whose pathogenesis is only poorly understood. Estrogens have a complex role in inflammation and growing evidence suggests that these hormones may impact IBD pathogenesis. Here, we demonstrated a significant reduction (p < 0.05) of estrogen receptor (ER)ß expression in peripheral blood T lymphocytes from CD/UC patients with active disease (n = 27) as compared to those in remission (n = 21) and healthy controls (n = 29). Accordingly, in a subgroup of CD/UC patients undergoing to anti-TNF-α therapy and responsive to treatment, ERß expression was higher (p < 0.01) than that observed in not responsive patients and comparable to that of control subjects. Notably, ERß expression was markedly decreased in colonic mucosa of CD/UC patients with active disease, reflecting the alterations observed in peripheral blood T cells. ERß expression inversely correlated with interleukin (IL)-6 serum levels and exogenous exposure of both T lymphocytes and intestinal epithelial cells to this cytokine resulted in ERß downregulation. These results demonstrate that the ER profile is altered in active IBD patients at both mucosal and systemic levels, at least in part due to IL-6 dysregulation, and highlight the potential exploitation of T cell-associated ERß as a biomarker of endoscopic disease activity.