A Case of Endocrine Cell Carcinoma and Adenocarcinoma of the Stomach

Takayuki Takahashi, Masato Fujisaki, Shinobu Hirahata, Dai Maeda, Hideyuki Tokura, Takashi Ohyama, Miho Shiota, Hisato Ishimatsu, Yoshinori Hoshino and Kazuhiko Shimizu*

Department of Surgery and Department of Pathology*, Ashikaga Red Cross Hospital

We report a case of endocrine cell carcinoma and adenocarcinoma of the stomach in synchronous multiple cancer. A 71-year-old man admitted for left-flank pain was found in endoscopy to have an open ulcer and irregular surrounding mucosa in the lesser curvature of the middle stomach. Biopsy showed adenocarcinoma. Upper gastrointestinal contrast radiography showed another lesion similar to a submucosal tumor with a central ulceration in the posterior wall of the middle body, only two months after the first examination. Abdominal CT showed no metastatic lesion in any organ. Laparoscopy-assisted distal gastrectomy with regional lymph node showed two tumors, one IIc+III cancer and the other tumor was suspected to be a submucosal tumor, diagnosed as moderately differentiated adenocarcinoma and endocrine cell carcinoma staining for synaptophysin and neuron-specific enolase (NSE). The two tumors were not related. Although gastric endocrine cell carcinoma prognosis is dismal, the patient remains alive 18 months after surgery.

Key words
gastric cancer, endocrine cell carcinoma, synchronous multiple cancer

Reprint requests
Takayuki Takahashi Department of Surgery, Ashikaga Red Cross Hospital
3-2100 Honjo, Ashikaga, 326-0808 JAPAN

Accepted
October 22, 2008

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