A Case of Neuroendocrine Cell Carcinoma and Poorly Differentiated Adenocarcinoma of the Stomach in Synchronous Multiple Cancer

Kenji Yasuda, Hidetoshi Fujiwara, Hideaki Nomura, Yoshifumi Sogo, Kenichi Sakai and Kazuhiro Teramura*

Department of Surgery, Wakakusa Dai-ichi Hospital
Department of Pathology, Yodogawa Christian Hospital*

A 74-year-old woman admitted for anemia was found in endscopy to have a Borrman type 2 tumor in the gastric body. Biopsy of the specimen showed poorly differentiated adenocarcinoma necessitating total gastrectomy, cholecystectomy, and splenectomy with esophagojejunostomy after Roux-en Y reconstruction. Multiple swollen lymph nodes were observed during surgery. Macroscopically, the surgical specimen showed 2 gastric tumors. Pathological evaluation of the 2 leasions disclosed that the tumor on the posterior wall was neuroendocrine cell carcinoma and the other was poorly differentiated adenocarcinoma. Immunohistochemically, only the tumor on the posterior wall showed positivity for grimelius, chromogranin A, and neuron-specific enolase (NSE) staining, as did lymph nodes. Electron micrography showed several dense-core granules in the cytoplasm of cells in the tumor on the posterior wall alone. Surgery was followed by chemotherapy with 5-FU (500 mg/day) and CDDP (10 mg/day). Despite subsequent oral 5-FU, the woman died in April 2003. We concluded that synchronous neuroendocrine cell carcinoma and poorly differentiated adenocarcinoma of the stomach is very rare.

Key words
neuroendocrine cell carcinoma, synchronous multiple cancer, stomach

Reprint requests
Kenji Yasuda Department of Surgery, Wakakusa Dai-ichi Hospital
1-6 Wakakusa-cho, Higashiosaka, 589-8056 JAPAN

Accepted
October 19, 2005

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