Journal of Gastric Cancer

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

DOI QR Code

Mixed Exocrine and Endocrine Carcinoma in the Stomach: A Case Report

  • Lee, Han-Hong (Division of Gastrointestinal Surgery, Department of Surgery, The Catholic University of Korea, School of Medicine) ;
  • Jung, Chan-Kwon (Division of Gastrointestinal Surgery, Department of Pathology, The Catholic University of Korea, School of Medicine) ;
  • Jung, Eun-Sun (Division of Gastrointestinal Surgery, Department of Pathology, The Catholic University of Korea, School of Medicine) ;
  • Song, Kyo-Young (Division of Gastrointestinal Surgery, Department of Surgery, The Catholic University of Korea, School of Medicine) ;
  • Jeon, Hae-Myung (Division of Gastrointestinal Surgery, Department of Surgery, The Catholic University of Korea, School of Medicine) ;
  • Park, Cho-Hyun (Division of Gastrointestinal Surgery, Department of Surgery, The Catholic University of Korea, School of Medicine)
  • Received : 2010.11.25
  • Accepted : 2011.01.05
  • Published : 2011.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

We report a rare case of the coexistence of a gastric small cell neuroendocrine carcinoma with a gastric adenocarcinoma. A 62-year-old man presented with epigastric soreness for 1 month. Esophagogastroduodenoscopy revealed a Borrmann type I tumor at the lesser curvature of the lower body of the stomach. The patient underwent a distal gastrectomy with D2 lymph node dissection and the resected specimen exhibited a $3.5{\times}3.5$ cm sized, fungating lesion. Two separated, not intermingling, lesions with non-adenocarcinoma components encircled by well differentiated adenocarcinoma components were identified microscopically. The non-adenocarcinoma component showed neuroendocrine features, such as a solid and trabecular pattern, and the tumor cells showed a high nuclear grade with minimal cytoplasm, indistinct nucleoli, and positive response for synaptophysin, CD56. The final pathological diagnosis was a gastric mixed exocrine-endocrine carcinoma (MEEC) composed of an adenocarcinoma and small cell neuroendocrine carcinoma of the collision type.

Keywords

References

  1. Solcia E, Kloppel G, Sobin LH, Capella C, DeLellis RA, Heitz PU, et al, eds. Histological Typing of Endocrine Tumours. WHO. World Health Organization. International Histological Classification of Tumours. 2nd ed. New York: Springer Verlag, 2000:56-70.
  2. Kloppel G, Anlauf M. Epidemiology, tumour biology and histopathological classification of neuroendocrine tumours of the gastrointestinal tract. Best Pract Res Clin Gastroenterol 2005;19:507-517. https://doi.org/10.1016/j.bpg.2005.02.010
  3. Kim EY, Park KC, Kwon JG. A case of double primary cancer: early gastric adenocarcinoma associated with adenocarcinoma and carcinoid. Korean J Gastroenterol 2003;42:533-538.
  4. Goteri G, Ranaldi R, Rezai B, Baccarini MG, Bearzi I. Synchronous mucosa-associated lymphoid tissue lymphoma and adenocarcinoma of the stomach. Am J Surg Pathol 1997;21:505- 509. https://doi.org/10.1097/00000478-199705000-00001
  5. Jiang SX, Mikami T, Umezawa A, Saegusa M, Kameya T, Okayasu I. Gastric large cell neuroendocrine carcinomas: a distinct clinicopathologic entity. Am J Surg Pathol 2006;30:945- 953. https://doi.org/10.1097/00000478-200608000-00003
  6. subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma: a clinicopathologic study. Gastroenterology 1993;104:994-1006.
  7. Volante M, Rindi G, Papotti M. The grey zone between pure (neuro)endocrine and non-(neuro)endocrine tumours: a comment on concepts and classification of mixed exocrineendocrine neoplasms. Virchows Arch 2006;449:499-506. https://doi.org/10.1007/s00428-006-0306-2
  8. Jain D, Eslami-Varzaneh F, Takano AM, Ayer U, Umashankar R, Muller R, et al. Composite glandular and endocrine tumors of the stomach with pancreatic acinar differentiation. Am J Surg Pathol 2005;29:1524-1529. https://doi.org/10.1097/01.pas.0000169498.89035.f9
  9. Capella C, La Rosa S, Uccella S, Billo P, Cornaggia M. Mixed endocrine-exocrine tumors of the gastrointestinal tract. Semin Diagn Pathol 2000;17:91-103.
  10. Haider K, Shahid RK, Finch D, Sami A, Ahmad I, Yadav S, et al. Extrapulmonary small cell cancer: a Canadian province's experience. Cancer 2006;107:2262-2269. https://doi.org/10.1002/cncr.22235
  11. Wong YN, Jack RH, Mak V, Henrik M, Davies EA. The epidemiology and survival of extrapulmonary small cell carcinoma in South East England, 1970-2004. BMC Cancer 2009;9:209. https://doi.org/10.1186/1471-2407-9-209
  12. Brenner B, Tang LH, Shia J, Klimstra DS, Kelsen DP. Small cell carcinomas of the gastrointestinal tract: clinicopathological features and treatment approach. Semin Oncol 2007;34:43-50. https://doi.org/10.1053/j.seminoncol.2006.10.022
  13. Walenkamp AM, Sonke GS, Sleijfer DT. Clinical and therapeutic aspects of extrapulmonary small cell carcinoma. Cancer Treat Rev 2009;35:228-236. https://doi.org/10.1016/j.ctrv.2008.10.007
  14. Rothenstein J, Cleary SP, Pond GR, Dale D, Gallinger S, Moore MJ, et al. Neuroendocrine tumors of the gastrointestinal tract: a decade of experience at the Princess Margaret Hospital. Am J Clin Oncol 2008;31:64-70. https://doi.org/10.1097/COC.0b013e31807a2f49
  15. Brennan SM, Gregory DL, Stillie A, Herschtal A, Mac Manus M, Ball DL. Should extrapulmonary small cell cancer be managed like small cell lung cancer? Cancer 2010;116:888-895. https://doi.org/10.1002/cncr.24858

Cited by

  1. Mixed Adenoneuroendocrine Gastric Carcinoma: A Case Report and Review of the Literature vol.14, pp.1, 2011, https://doi.org/10.5230/jgc.2014.14.1.63
  2. Gastric Collision Tumors: An Insight into Their Origin and Clinical Significance vol.2015, pp.None, 2011, https://doi.org/10.1155/2015/314158
  3. Mixed adenoneuroendocrine carcinoma of the ampulla: Two case reports vol.21, pp.7, 2011, https://doi.org/10.3748/wjg.v21.i7.2254
  4. Prognostic value of 18F-fluorodeoxyglucose positron emission tomography in patients with gastric neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma vol.30, pp.4, 2016, https://doi.org/10.1007/s12149-016-1059-x
  5. Case of a tumor comprising gastric cancer and duodenal neuroendocrine tumor vol.22, pp.36, 2011, https://doi.org/10.3748/wjg.v22.i36.8242
  6. A mixed adenoneuroendocrine carcinoma of the pancreas: a case report vol.2, pp.None, 2011, https://doi.org/10.1186/s40792-016-0263-1
  7. Correlation of metastasis characteristics with prognosis in gastric mixed adenoneuroendocrine carcinoma : Two case reports vol.96, pp.50, 2011, https://doi.org/10.1097/md.0000000000009189
  8. Gastric Pouch Mixed Adenoneuroendocrine Carcinoma With a Mixed Adenocarcinoma Component After Roux-en-Y Gastric Bypass vol.5, pp.4, 2017, https://doi.org/10.1177/2324709617740908
  9. Mixed adenoneuroendocrine carcinoma of the esophagogastric junction: a case report vol.4, pp.None, 2011, https://doi.org/10.1186/s40792-018-0464-x
  10. Efficacy of XELOX adjuvant chemotherapy for gastric mixed adenoneuroendocrine carcinoma : A case report vol.98, pp.23, 2011, https://doi.org/10.1097/md.0000000000016000
  11. Diagnosis of Mixed Adenoneuroendocrine Carcinoma (MANEC) after Neoadjuvant Chemotherapy for Pancreatic and Gastric Adenocarcinoma: Two Case Reports and a Review of the Literature vol.12, pp.2, 2011, https://doi.org/10.1159/000501200
  12. Mixed adenoneuroendocrine carcinoma (MANEC) of the ampulla of Vater in a Chinese patient: A case report vol.48, pp.8, 2011, https://doi.org/10.1177/0300060520947918
  13. Collision Tumor of the Stomach vol.15, pp.1, 2021, https://doi.org/10.1159/000514395
  14. Clinicopathological features and lymph node and distant metastasis patterns in patients with gastroenteropancreatic mixed neuroendocrine‐non‐neuroendocrine neoplasm vol.10, pp.14, 2011, https://doi.org/10.1002/cam4.4031
  15. Gastric Mixed Adenoneuroendocrine Carcinoma with Revised Diagnosis after Retrospective Pathologic Review vol.21, pp.4, 2011, https://doi.org/10.7704/kjhugr.2021.0047