Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지
DOI QR코드

DOI QR Code

Neuroendocrine Tumor of Unknown Primary Accompanied with Stomach Adenocarcinoma

  • Kim, Ho-Yeun (Department of Surgery, Kyung-Hee University School of Medicine) ;
  • Choi, Sung-Il (Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung-Hee University School of Medicine) ;
  • Kim, Young-Ho (Department of Surgery, Kyung-Hee University School of Medicine)
  • Received : 2011.12.08
  • Accepted : 2011.12.15
  • Published : 2011.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

A 67 year old male at a regular checkup underwent esophagogastroduodenoscopy. On performing esophagogastroduodenoscopy, a lesion about 1.2 cm depressed was noted at the gastric angle. The pathology of the biopsy specimen revealed a well-differentiated adenocarcinoma. On performing an abdominal computed tomography (CT) scan & positron emission tomography-computed tomography (PET-CT) scan, no definite evidence of gastric wall thickening or mass lesion was found. However, lymph node enlargement was found in the left gastric and prepancreatic spaces. This patient underwent laparoscopic assisted distal gastrectomy and D2 lymph node dissection. On final examination, it was found out that the tumor had invaded the mucosal layer. The lymph node was a metastasized large cell neuroendocrine carcinoma with an unknown primary site. The patient refused chemotherapy. He opted to undergo a close followup. At the postoperative month 27, he had a focal hypermetabolic lesion in the left lobe of the liver that suggested metastasis on PET-CT scan. He refused to undergo an operation. He underwent a radiofrequency ablation.

Keywords

References

  1. Fizazi K, Greco FA, Pavlidis N, Pentheroudakis G; ESMO Guidelines Working Group. Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2011;22 Suppl 6:vi64-68.
  2. Stoyianni A, Pentheroudakis G, Pavlidis N. Neuroendocrine carcinoma of unknown primary: a systematic review of the literature and a comparative study with other neuroendocrine tumors. Cancer Treat Rev 2011;37:358-365. https://doi.org/10.1016/j.ctrv.2011.03.002
  3. Spigel DR, Hainsworth JD, Greco FA. Neuroendocrine carcinoma of unknown primary site. Semin Oncol 2009;36:52-59. https://doi.org/10.1053/j.seminoncol.2008.10.003
  4. Tot T. Adenocarcinomas metastatic to the liver: the value of cytokeratins 20 and 7 in the search for unknown primary tumors. Cancer 1999;85:171-177. https://doi.org/10.1002/(SICI)1097-0142(19990101)85:1<171::AID-CNCR24>3.0.CO;2-V
  5. Tot T. Cytokeratins 20 and 7 as biomarkers: usefulness in discriminating primary from metastatic adenocarcinoma. Eur J Cancer 2002;38:758-763. https://doi.org/10.1016/S0959-8049(02)00008-4
  6. Pavlidis N, Briasoulis E, Hainsworth J, Greco FA. Diagnostic and therapeutic management of cancer of an unknown primary. Eur J Cancer 2003;39:1990-2005. https://doi.org/10.1016/S0959-8049(03)00547-1
  7. Rindi G, D'Adda T, Froio E, Fellegara G, Bordi C. Prognostic factors in gastrointestinal endocrine tumors. Endocr Pathol 2007;18:145-149. https://doi.org/10.1007/s12022-007-0020-x
  8. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003;97:934-959. https://doi.org/10.1002/cncr.11105
  9. Norheim I, Oberg K, Th eodorsson-Norheim E, Lindgren PG, Lundqvist G, Magnusson A, et al. Malignant carcinoid tumors. An analysis of 103 patients with regard to tumor localization, hormone production, and survival. Ann Surg 1987;206:115-125. https://doi.org/10.1097/00000658-198708000-00001
  10. Oberg K, Eriksson B. Endocrine tumours of the pancreas. Best Pract Res Clin Gastroenterol 2005;19:753-781. https://doi.org/10.1016/j.bpg.2005.06.002
  11. Starker LF, Carling T. Molecular genetics of gastroenteropancreatic neuroendocrine tumors. Curr Opin Oncol 2009;21:29-33. https://doi.org/10.1097/CCO.0b013e328319ea7b
  12. McDermott EW, Guduric B, Brennan MF. Prognostic variables in patients with gastrointestinal carcinoid tumours. Br J Surg 1994;81:1007-1009. https://doi.org/10.1002/bjs.1800810725
  13. Th ompson GB, van Heerden JA, Grant CS, Carney JA, Ilstrup DM. Islet cell carcinomas of the pancreas: a twenty-year experience. Surgery 1988;104:1011-1017.
  14. Zeitels J, Naunheim K, Kaplan EL, Straus F 2nd. Carcinoid tumors: a 37-year experience. Arch Surg 1982;117:732-737. https://doi.org/10.1001/archsurg.1982.01380290176031
  15. Wang SC, Parekh JR, Zuraek MB, Venook AP, Bergsland EK, Warren RS, et al. Identification of unknown primary tumors in patients with neuroendocrine liver metastases. Arch Surg 2010;145:276-280. https://doi.org/10.1001/archsurg.2010.10

Cited by

  1. Submucosal small-cell neuroendocrine carcinoma of the larynx detected using 18 F-fluorodeoxyglucose positron emission tomography/computed tomography: A case report and review of the litera vol.8, pp.3, 2011, https://doi.org/10.3892/ol.2014.2246