Gastric mixed adenoneuroendocrine carcinoma occurring 30 years after a gastroenterostomy

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Published Jan 3, 2019
DOI: https://doi.org/10.22551/2018.21.0504.10141
Mihaela Mădălina Gavrilescu Ionuț Huțanu Ana-Maria Mușină Mihaela Buna-Arvinte Ana Maria Patrașcu Iulian Radu Bogdan Filip Maria Gabriela Aniței Dragoș Viorel Scripcariu Viorel Scripcariu

Abstract

Gastroenteropancreatic neuroendocrine carcinomas (GEP-NENs) represent a heterogeneous group of rare tumors. The incidence of GEP-NENs has increased worldwide over the past decades, with the small intestine, rectum, and pancreas as the most common tumor locations. The epidemiological characteristics, pathogenesis and treatment have raised many questions, and some of them are still being debated. Here, we report a case of gastric collision tumor with large-cell neuroendocrine carcinoma and adenocarcinoma. A 73-year-old male patient with a history of gastric resection performed 30 years ago, with no medical records revealing the type of resection or the reconstructive way, presented with epigastric pain. The endoscopy revealed a solid, ulcerated mass at the gastrojejunal anastomosis site from which a tissue biopsy was taken, which was reported as adenocarcinoma. For staging, the patient underwent an abdominal CT scan, which showed the thickening of the gastric wall adjacent to anastomosis and perilesional adenopathy. The patient underwent a subtotal gastrectomy and regional lymphadenectomy. A diagnosis of large-cell neuroendocrine carcinoma developed on the gastric stump associated with isolated foci of moderately differentiated tubular adenocarcinoma pT3N1G3 was made. Immunohistochemical analysis is essential for the diagnosis and classification of the lesion. To confirm the diagnosis, Chromogranin A and Synaptophysin are needed, and for prognostic evaluation the identification of Ki-67 and mitotic figure count are required.

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Keywords

neuroendocrine tumor, gastric carcinoma, adenoneuroendocrine carcinoma, G-NET, surgery

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How to Cite
Gavrilescu, M. M., Huțanu, I., Mușină, A.-M., Buna-Arvinte, M., Patrașcu, A. M., Radu, I., Filip, B., Aniței, M. G., Scripcariu, D. V., & Scripcariu, V. (2019). Gastric mixed adenoneuroendocrine carcinoma occurring 30 years after a gastroenterostomy. Archive of Clinical Cases, 5(4), Arch Clin Cases 2018; 5(4):140-145. https://doi.org/10.22551/2018.21.0504.10141
Issue
Vol. 5 No. 4 (2018)
Section
Case Reports

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How to Cite

Gavrilescu, M. M., Huțanu, I., Mușină, A.-M., Buna-Arvinte, M., Patrașcu, A. M., Radu, I., Filip, B., Aniței, M. G., Scripcariu, D. V., & Scripcariu, V. (2019). Gastric mixed adenoneuroendocrine carcinoma occurring 30 years after a gastroenterostomy. Archive of Clinical Cases, 5(4), Arch Clin Cases 2018; 5(4):140-145. https://doi.org/10.22551/2018.21.0504.10141