Clinicopathological Study of Eight Cases of Gastric Neuroendocrine Carcinoma

Keishiro Aoyagi, Junya Kizaki, Taro Isobe, Taizan Minami and Yoshito Akagi

Department of Surgery, Kurume University School of Medicine, Japan

^*Correspondance to: Keishiro Aoyagi 

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Abstract:

Neuroendocrine carcinoma (NEC) of the stomach accounts for 0.1% to 0.6% of all gastric carcinomas, and its prognosis is poor. This report describes eight patients with NEC of the stomach. Only one patient had been correctly diagnosed before surgery; the others had been misdiagnosed with tubular adenocarcinoma, poorly differentiated adenocarcinoma, and malignant lymphoma. Five patients had type 2 cancer on macroscopic examination. Histological findings of the resected specimens showed that three NECs were associated with tubular adenocarcinoma and that one was associated with signet ring cell carcinoma. Liver metastases were found in four patients, but none had peritoneal metastases. The cancer stroma volume and tumor infiltration indicated the medullary type in seven patients and expanding growth type in six. Neither the scirrhous type nor infiltrative growth type was found. All eight patients had moderate or marked lymphatic invasion, and six had venous invasion. Six patients underwent postoperative chemotherapy. The median survival time was 10 months, and the 5-year survival rate was 37.5%. The causes of death were liver metastases in five patients and metastases to the lung and brain in one. One patient with lung metastasis who underwent multimodal treatment comprising surgery, radiation, and chemotherapy with cisplatin + irinotecan and S-1 + paclitaxel remained alive for 74 months postoperatively. NEC was difficult to diagnose preoperatively. High frequencies of capillary invasion and hematogenous metastasis, such as to the liver, were observed, and the prognosis was poor. However, long-term survival was higher among patients with NEC who underwent multimodal therapy.

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Cite the Article:

Aoyagi K, Kizaki J, Isobe T, Minami T, Akagi Y. Clinicopathological Study of Eight Cases of Gastric Neuroendocrine Carcinoma. Ann Clin Case Rep. 2016; 1: 1197.