A Case of Neuroendocrine Cell Carcinoma in Remnant Stomach with Direct Invasion to the Pancreas

Sadatoshi Sugae, Yasuhiko Nagano, Masazumi Takahashi, Kazutaka Koganei, Yasuhisa Mochizuki, Tohru Kubota, Fumihiko Kitoh and Tsuneo Fukushima

Department of Surgery, Yokohama Municipal Hospital

A 69-year-old man admitted for anemia underwent distal gastrectomy and Billroth-II reconstruction at the age of 50 for a duodenal ulcer. In November 2002, he was found in upper gastrointestinal endoscopy to have a type 3 tumor at the posterior wall of the remnant stomach. Biopsy specimens showed poorly differentiated adenocarcinoma. Abdominal enhanced CT showed an extraluminal mass 8 cm in diameter. Pancreatic invasion was ruled out due to the unclear margin between the tumor and pancreas. Based on a diagnosis of remnant stomach carcinoma with direct pancreatic invasion, we resected the remnant stomach, conducting splenectomy and distal pancreatomy. Pathological findings showed large and small nests and carcinoma cells staining positively for chromogranin-A and synaptophisin. The definitive diagnosis was neuroendcrine cell carcinoma, a highly malignant disease with a dismal prognosis. Neuroendocrine cell carcinoma of the remnant stomach is rare, with only 6 cases reported in Japan to our knowledge.

Key words
neuroendocrine cell carcinoma, remnant stomach

Reprint requests
Sadatoshi Sugae Department of Gastroenterological Surgery, Yokohama City Graduate University, School of Medicine
3-9 Fukuura, Kanazawaku, Yokohama, 236-0004 JAPAN

Accepted
October 19, 2005

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