Case Report: A Poorly Differentiated Adenocarcinoma with Medullary Growth Pattern of the Stomach Showing High Serum Neuron-specific Endolase and High Sensitivity to the Chemotherapy

Michio Maruyama, Toshihumi Kudo, Hiroshi Kuwabara, Susumu Takamatsu, Norihide Sugano, Masakazu Ebuchi

Department of Surgery, Tokyo City Hospital, Ohkubo

This case is a 74-year-old woman with gastric cancer case who had poorly differentiated carcinoma with a medullary growth pattern (porl) and its extensive hepatic metastasis (H3). This patient had a high level of serum NSE (140 ng/ml). Total gastrectomy and hepatic artery catheterization were performed. In the resected original tumor and a hepatic metastasis biopsy, positive immuno-histochemical examination for NSE and aynaptophysin revealed the neuroendocrine differentiation of the tumor cells. Postoperative hepatic intra-arterial chemotherapy with CDDP/5FU caused a dramatic response of the huge hepatic metastases. Lung and esophageal carcinomas with high serum NSE levels have been reported as high responders to the chemotherapy. Of gastric cancers, porl gastric carcinoma with high serum NSE levels showed not only high rates of hematogenic metastasis but high sensitivity to chemotherapy.

Key words
neuron-specific enolase, gastric cancer with medullary growth pattern, chemosensitivity

Reprint requests
Michio Maruyama Department of Surgery, Tokyo City Hospital, Ohkubo
2-44-1 Kabukicho, Shinjuku-ku, Tokyo, 160 JAPAN

Accepted
March 19, 1997

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