Gastric Endocrine Cell Carcinoma Coexistent with Adenocarcinoma
A 69-year-old female presented to our institution with epigastralgia and abdominal distension. Upper gastrointestinal series revealed a 5 cm ulcerative lesion with irregular margins and elevated distinct borders from the angle to the pyloric ring. Gastroendoscopy...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2013/502451 |
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| Summary: | A 69-year-old female presented to our institution with epigastralgia and abdominal
distension. Upper gastrointestinal series revealed a 5 cm ulcerative lesion with irregular
margins and elevated distinct borders from the angle to the pyloric ring.
Gastroendoscopy revealed a Borrmann type 2 tumor. Several biopsied specimens
revealed proliferation of small and heterogeneous cancer cells with rich chromatin and
fibrous septum with rich vessels at connective tissues, which was confirmed as gastric
endocrine cell carcinoma (ECC) on immunostaining with chromogranin and
synaptophysin. Furthermore, other specimens revealed atypical cells forming glandular
structures, which were confirmed as well-differentiated tubular adenocarcinomas. Distal
gastrectomy with D2 lymph node dissection and Billroth I reconstruction was
performed. Pathological examination of the gross specimen revealed that
adenocarcinoma comprised <10% of all cancer cells. Close analysis of ECC revealed a
mixture of small and large cells. According to the WHO 2010 classification of
gastrointestinal neuroendocrine tumors, this gastric tumor was diagnosed as
neuroendocrine carcinoma. The patient was administered adjuvant chemotherapy with
cisplatin and etoposide. One year following surgery, follow-up abdominal CT revealed
multiple liver metastases. The patient received the best supportive care but eventually
died 18 months after surgery. Here we present this case of gastric ECC coexistent with
adenocarcinoma. |
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| ISSN: | 1687-9627 1687-9635 |