A Case of Gastric Endocrine Cell Carcinoma with Intramural Metastasis Invading Mainly the Muscle Layer

Takaki Yoshikawa, Kohei Ando, Akiko Shotsu, Naoki Ishiwa, Soichiro Morinaga, Yoshikazu Noguchi, Yuji Yamamoto, Sachiko Yoshida*, Akira Tsuburaya** and Osamu Kobayashi**

The Department of Surgery Yokohama City Kowan Hospital
The Department of Pathology, Yokohama City Kowan Hospital*
The Department of Gastrointestinal Surgery, Kanagawa Cancer Center**

A 58 years old female was admitted with a loss of appetite. Endoscopic examination revealed a type 2 gastric cancer located at the anterior wall of the antrum and submucosal tumor at the pre-pylorus. She underwent distal gastrectomy with D3 lymph node dissection. Pathological examinations of type 2 tumor demonstrated endocrine cell carcinoma proliferating in the muscular layer. Submucosal tumor at the prepylorus consisted of endocrine cell carcinoma proliferating in the muscle and the subserosal layers. Gastric endocrine cell carcinoma is a rare disease characterized by high malignant potential. Topographical locations of two lesions with normal tissue between them suggested the intramural metastasis.

Key words
gastric cancer, intramural metastasis, endocrine cell carcinoma

Reprint requests
Takaki Yoshikawa The Department of Gastrointestinal Surgery, Kanagawa Cancer Center
1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815 JAPAN

Accepted
September 22, 2004

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