Gastric Mixed Neuroendocrine-Nonneuroendocrine Neoplasm: A rare case report
Article Sidebar
Main Article Content
Abstract
Objective: The incidence of gastric neuroendocrine neoplasms is less than 1%. They are seen as combined tumors with non-neuroendocrine neoplasms at a rate of approximately 7%. This study aims to share the case of mixed neuroendocrine and non-neuroendocrine cancer with the literature.
Case: Endoscopic biopsies were taken from the tumoral mass detected in the gastric cardia region at endoscopy in a 60-year-old male patient that has complaints of weight loss and epigastric pain. Histopathological examination revealed malignant tumor infiltration that consisting of neuroendocrine cells with large nuclei and narrow cytoplasm in some areas and adenoid structures composed of atypical cells with pleomorphic large nuclei in some areas. Strong staining was observed in neuroendocrine areas with neuroendocrine markers such as synaptophysin and Chromogranin. Ki-67 proliferative index and mitotic activity were high in neuroendocrine neoplasm areas. The case was reported as a high-grade neuroendocrine-non neuroendocrine mixed neoplasm.
Conclusion: Gastric Mixed Neuroendocrine-Nonneuroendocrine neoplasms are rare cases and correct diagnosis and grading are important in the treatment and patient follow-up protocol.
Downloads
Article Details
Accepted 2021-04-16
Published 2021-04-19
References
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;6: 394-424
Llanos O, Butte JM, Crovari F, Duarte I, Sergio Guzmán S . Survival of young patients after gastrectomy for gastric cancer. World J Surg 2006;1: 17–20
Shaukat A, Wang A, Acosta RD, Bruining DH, Chandrasekhara V, Chathadi KV, et al. The role of endoscopy in dyspepsia. Gastrointestinal Endoscopy 2015;2: 227-232
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: globocan 2008. Int J Cancer 2010;12: 2893–917
Hirabiyashi K, Zamboni G, Nishi T, Tanaka A. Histopathology of gastrointestinal neuroendocrine neoplasms. Frontiers in Oncology 2013;2: 1-11
Lepage C, Bouvier AM, Faivre J: Endocrine tumours: epidemiology of malignant digestive neuroendocrine tumours. Eur J Endocrinol 2013;4: 77-83
Matsubayashi H, Takagaki S, Otsubo T, Iiri T, Kobayashi Y, Yokota T, et al. Advanced gastric glandular-endocrine cell carcinoma with 1-year survival after gastrectomy. Gastric Cancer 2000;3: 226-233
La Rosa S, Inzani F, Vanoli A, Klersy C, Dainese L, Rindi G, et al. Histologic characterization and improved prognostic evaluation of 209 gastric neuroendocrine neoplasms. Hum Pathol 2011;10: 1373-1384
de Mestier L, Cros J, Neuzillet C, Hentic O, Egal A, Muller N, et al. Digestive system mixed neuroendocrine-non-neuroendocrine neoplasms. Neuroendocrinology 2017;105:412–425.
Klöppel G, Couvelard A, Hruban RH, Klimstra DS, Komminoth P, Osamura RY, et al: Neoplasms of the neuroendocrine pancreas; in: WHO Classification of Tumours of the Endocrine Organs, ed 4. Lyon, IARC Press, 2017, 210-239
Volante M, Monica V, Birocco N, Brizzi MP, Busso S, Daniele L, et al. Expression analysis of genes involved in DNA repair or synthesis in mixed neuroendocrine/nonneuroendocrine carcinomas. Neuroendocrinology 2015;2: 151-160
Yao J, Phan A. Optimising therapeutic options for patients with advanced pancreatic neuroendocrine tumours. Eur Oncol Haematol. 2012;8: 217–223
Kubota T, Ohyama S, Hiki N, Nunobe S, Yamamoto N, Yamaguchi T. Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute. Gastric Cancer. 2012;3: 323–330
La Rosa S, Marando A, Sessa F, Capella C. Mixed adenoneuroendocrine carcinomas (MANECs) of the gastrointestinal tract: an update. Cancers 2012;4: 11-30
Oberg K, Kvols L, Caplin M, Delle Fave G, de Herder W, Rindi G, et al. Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumors of the gastroenteropancreatic system. Ann Oncol. 2004;6: 966–973
Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, et al. One hundred years after carcinoid: epidemiology and prognostic factors for neuroendocrine tumors in 35.825 cases in United States. J Clin Oncol 2008;6: 3063-3072