A Case of Gastric Endocrine Cell Carcinoma Combined with Adenocarcinoam in the Sigmoid Colon

Mitsuharu Nakamoto, Katsunori Kawaguchi, Sirou Nakae, Yukio Nishio, Tomoaki Urakawa, Teruo Ioroi, Kiyoshi Uematsu, Takahiro Fujimori*

Department of Surgery, Kobe Rosai Hospital of the Labour Welfare Corporation
*Second Department of Pathology, School of Medicine, Kobe University

A 79-year-old man was admitted to our hospital with epigastric pain. An upper gastro-intestinal study revealed a giant tumor in the antrum, and a barium enema study showed a tumor in the sigmoid colon. Distal gastrectomy and sigmoidectomy were performed. Histologically, the tumor in the sigmoid colon was found to be invaded by a well-differentiated adenocarcinoma. But the tumor in the stomach showed expansive growth to the subserosa, the tumor cells were small or medium sized, nuclear chromatin was increased, and argyrophilic granules were demonstrated in the cytoplasm by Grimelius staining. Immunohistochemically, gastric tumor cells were found to be positive for neuron-specific enolase, but negative for epithelial membrane antigen and carcinoembryonic antigen. In this way, the diagnosis of an endocrine cell carcinoma of the stomach was made. Although the gastric endocrine cell carcinoma showed marked vascular permeation, no lymph node or hepatic invasion was found. A large metastatic liver tumor was found 14 months later, and the patient died 17 months after the operation.

Key words
endocrine cell carcinoma of stomach, double cancers of stomach and colon

Reprint requests
Mitsuharu Nakamoto Department of Surgery, Kobe Rosai Hospital of the Labour Welfare Corporation
9-12 Bessho-cho, Akashi-shi, 673 JAPAN

Accepted
April 1, 1992

To read the PDF file you will need Abobe Reader installed on your computer.