Title: Neuroendocrine Carcinoma of Stomach: A Case Report and Review of Literature
Authors: Dr Jagdish Gupta, Dr Archit Gupta, Dr Pankaj Chandel, Dr Arun Gupta, Dr Bhavesh Devkaran, Dr Arun Chauhan
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.99
Abstract
Neuroendocrine neoplasms are rare tumors of stomach. In stomach these usually arise from enterochro-maffin cells of Kulchitsky and can vary from benign to highly malignant tumors. These are divided into four distinct groups according to their clinicopathological behaviour. Type 1 are usually benign, are associated with chronic atrophic gastritis and carry a good prognosis. Type 2 are similar to type 1 in clinical presentation but metastatise in around 10-30% patients. Type 3 are sporadic, usually more than 2cm in size and need radical surgery. Type 4 are poorly differentiated, highly malignant tumors and carry a very poor prognosis.
Here we present a case of type 3 neuroendocrine carcinoma of the stomach which was diagnosed postoperatively by histopathology and confirmed by immunohistochemistry. The patient underwent a total gastrectomy with splenectomy with distal pancreatectomy with roux en-y-oesophagojejunostomy. We present this case due to its rarity. Review of literature done to emphasise the types and treatment of these tumors.
Keywords: Neuroendocrine neoplasms,clinicopathologic,immunohistochemistry.
References
1. Chiba N, Suwa T, Hori M, Sakuma M, and Kitajima M. Advanced gastric endocrine cell carcinona with distant lymph node metastasis: a case report and clinicopathological characteristics of the disease. Gastric Cancer. 2004;7(2):122–27
2. Gilligan CJ, Lawton GP, Tang LH, West AB, Modlin IM. Gastric carcinoid tumors: the biology and therapy of an enigmatic and controversial lesion. Am J Gastroenterol. 1995;90:338–352
3. Ahlman H, Kölby L, Lundell L, Olbe L, Wängberg B, Granérus G, Grimelius L, Nilsson O. Clinical management of gastric carcinoid tumors. Digestion. 1994;55 Suppl 3:77–85
4. Hosoya Y, Fujii T, Nagai H, Shibusawa H, Tsukahara M, Kanazawa K. A case of multiple gastric carcinoids associated with multiple endocrine neoplasia type 1 without hypergastrinemia. Gastrointest Endosc. 1999;50:692–695
5. Li T-T, Qiu F, Qian ZR, Wan J, Qi X-K, Wu B-Y. Classification, clinicopathologic features and treatment of gastric neuroendocrine tumors. World Journal of Gastroenterology : WJG. 2014;20(1):118-125. doi:10.3748/wjg.v20.i1.118.
6. Lubarsch O. Ûber der primären Krebs des ileum, nebst Bemerkungenüber das gleichze-itigeVorkommen von Krebs und Tuberkulose. Virchows Arch. 1888; 111: 281-317.
7. Ranson WB. A case of primary carcinoma of the ileum. Lancet. 2005;2:1020-1023.
8. Oberndorfer S. KarzinoideTumoren des Dünndarms. Frankfurt Zellforsch Pathologie. 1907;1:426-429
9. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003;97:934–959
10. Von Askanazy M. ZurPathogenese der Magenkarzinoide and überihrengele-gentlichen Ursprungausangeborenenepi-thelialen Keimen in der Magenwand. Dtsch Med Wochenschr. 1923;49:49-51
11. Christodoulopoulos JB, Klotz AP. Carcinoid syndrome with primary carcinoid tumor of the stomach. Gastroenterology. 1961;40: 429-440
12. La Rosa S, Vanoli A. Gastric neuroendocrine neoplasms and related precursor lesions. Journal of Clinical Pathology 2014;67:938-948.
13. Kaizaki Y, Fujii T, Kawai T, Saito K, Kurihara K, Fukayama M. Gastric neuroendocrine carcinoma associated with chronic atrophic gastritis type A. J Gastroenterol. 1997;32:643–649
14. Crosby DA, Donohoe CL, Fitzgerald L, Muldoon C, Hayes B, O’Toole D, Reynolds JV. Gastric neuroendocrine tumours. Dig Surg. 2012;29:331–348
15. DelleFave G, Capurso G, Annibale B, Panzuto F. Gastric neuroendocrine tumors. Neuroendocrinology. 2004;80 Suppl 1:16–19
16. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine Tumors, Version 2.2016. NCCN. Available at http://www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. May 25, 2016; Accessed: 14 February, 2017
17. Fossmark R, Sørdal Ø, Jianu CS, Qvigstad G, Nordrum IS, Boyce M, Waldum HL. Treatment of gastric carcinoids type 1 with the gastrin receptor antagonist netazepide (YF476) results in regression of tumours and normalisation of serum chromogranin A. Aliment Pharmacol Ther. 2012;36: 1067–1075
18. Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD. Current status of gastrointestinal carcinoids. Gastroenter-ology. 2005;128:1717–1751
19. Tomassetti P, Migliori M, Caletti GC, Fusaroli P, Corinaldesi R, Gullo L. Treatment of type II gastric carcinoid tumors with somatostatin analogues. N Engl J Med. 2000;343:551–554
20. Hosoya Y, Nagai H, Koinuma K, Yasuda Y, Kaneko Y, Saito K. A case of aggressive neuroendocrine carcinoma of the stomach. Gastric Cancer. 2003;6:55–59
21. Li T-T, Qiu F, Qian ZR, Wan J, Qi X-K, Wu B-Y. Classification, clinicopathologic features and treatment of gastric neuroendocrine tumors. World Journal of Gastroenterology : WJG. 2014;20(1):118-125
22. Kidd M, Gustafsson BI. Management of gastric carcinoids (neuroendocrine neoplasms) CurrGastroenterol Rep. 2012;14:467–472
23. Namikawa T, Oki T, Kitagawa H, Okabayashi T, Kobayashi M, Hanazaki K. Neuroendocrine carcinoma of the stomach: clinicopathological and immunohisto-chemical evaluation. Med MolMorphol. 2013;46:34–40
24. Bosman FT, Carneiro F, Hruban RH, Theise ND, eds. WHO Classification of Tumours of the Digestive System. Geneva, Switzerland: WHO Press; 2010.
25. Rindi G, Kloppel G, Alhman H, et al; and all other Frascati Consensus Conference participants; European Neuroendocrine Tumor Society (ENETS). TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system. Virchows Arch. 2006;449(4):395-401.