A Case of Gastric Large Cell Neuroendocrine Carcinoma with Multiple Liver Metastasis Treated with Hepatic Artery Infusion Chemotherapy Followed by Surgery

  • Sung Bum Kim (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Kook Hyun Kim (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Tae Nyeun Kim (Department of Internal Medicine, Yeungnam University College of Medicine)
  • Received : 2015.05.26
  • Accepted : 2015.06.24
  • Published : 2015.06.30

Abstract

A 73-year-old male visited our hospital with a complaint of general weakness. He underwent pyloric preserving pancreas-toduodenectomy due to ampullary cancer three years ago. Abdominal computed tomography scan at initial visit revealed multiple hepatic masses. A PET-CT scan showed multiple FDG uptakes at whole liver. He underwent hepatic artery infusion chemotherapy (HAIC) for five cycles. During the first cycle of HAIC, he developed gastric ulcer bleeding and endoscopic hemostasis was done successfully. Esophagogastroduodenoscopy after the 5th cycle of HAIC revealed ulcer scar at gastric angle. PET-CT scan at 12 months showed no FDG uptake at liver, but a focal FDG uptakes at stomach and peri-gastric lymph nodes were newly developed. Esophagogastroduodenoscopy revealed about 3 cm sized mass at gastric angle. He underwent surgery and pathologic examination revealed large cell neuroendocrine carcinoma. We report a case of gastric large cell neuroendocrine carcinoma with liver metastasis treated with HAIC followed by surgery.

Keywords

References

  1. Modlin IM, Oberg K, Chung DC, et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol 2008;9:61-72.
  2. Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumours of the digestive system, World Health Organization, 2010.
  3. 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.
  4. National Cancer Institute (U.S.). Common terminology criteria for adverse events (CTCAE). Rev. ed. p194 p., Bethesda, Md., U.S. Dept. of Health and Human Services, National Institutes of Health, National Cancer Institute, 2009.
  5. Yildiz O, Ozguroglu M, Yanmaz T, Turna H, Serdengecti S, Dogusoy G. Gastroenteropancreatic neuroendocrine tumors: 10-year experience in a single center. Med Oncol 2010;27:1050-1056.
  6. Rindi G, Bordi C, Rappel S, La Rosa S, Stolte M, Solcia E. Gastric carcinoids and neuroendocrine carcinomas: pathogenesis, pathology, and behavior. World J Surg 1996;20:168-172.
  7. Boo YJ, Park SS, Kim JH, Mok YJ, Kim SJ, Kim CS. Gastric neuroendocrine carcinoma: clinicopathologic review and immunohistochemical study of E-cadherin and Ki-67 as prognostic markers. J Surg Oncol 2007;95:110-117.
  8. Namikawa T, Oki T, Kitagawa H, Okabayashi T, Kobayashi M, Hanazaki K. Neuroendocrine carcinoma of the stomach: clinicopathological and immunohistochemical evaluation. Med Mol Morphol 2013;46:34-40.
  9. QModlin IM, Latich I, Kidd M, Zikusoka M, Eick G. Therapeutic options for gastrointestinal carcinoids. Clin Gastroenterol Hepatol 2006;4:526-547.
  10. Belhocine T, Foidart J, Rigo P, et al. Fluorodeoxyglucose positron emission tomography and somatostatin receptor scintigraphy for diagnosing and staging carcinoid tumours: correlations with the pathological indexes p53 and Ki-67. Nucl Med Commun 2002;23:727-734.
  11. Kulke MH, Wu B, Ryan DP, et al. A phase II trial of irinotecan and cisplatin in patients with metastatic neuroendocrine tumors. Dig Dis Sci 2006;51:1033-1038.
  12. Fjallskog ML, Granberg DP, Welin SL, et al. Treatment with cisplatin and etoposide in patients with neuroendocrine tumors. Cancer 2001;92:1101-1107.