title: Primary small cell carcinoma of the stomach.
abstract: We report on an 80-year-old man with primary gastric small cell carcinoma (SmCC). He was admitted to hospital with hematemesis. An upper gastrointestinal examination revealed an irregularly ulcerated tumor, 60 mm in diameter, on the lesser curvature of the stomach body extending to the cardia. An endoscopic biopsy revealed a solid proliferation of intermediate-sized tumor cells with hyperchromatic nuclei and scanty cytoplasm. Immunohistochemically, the neoplastic cells were positive for neuron-specific enolase and chromogranin A, but negative for carcinoembryonic antigen. No tumor was detected on examination of the chest. Therefore, primary gastric SmCC was diagnosed preoperatively. To date, only 38 cases of primary gastric SmCC, including our case, have been reported. By using endoscopic biopsy, approximately two-thirds of cases have been diagnosed incorrectly. In the reported cases of gastric SmCC, the endoscopic findings frequently indicated a submucosal tumor. Gastric SmCC is clinically aggressive and has an extremely poor prognosis, even when discovered at an early stage. Most patients with gastric SmCC die within 1 year of diagnosis. Although a standard treatment for gastric SmCC has not been established, intensive chemotherapy should be considered to promote long-term survival. We believe that careful examination, including immunohistochemical investigation, is necessary for determining the therapeutic strategy whenever gastric SmCC is suspected during endoscopy.
authors.affiliation: Second Department of Internal Medicine, Showa University School of Medicine, Showa University Hospital, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kusayanagi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Konishi
authors.forename: Nobuo
authors.initials: N
authors.lastname: Miyasaka
authors.forename: Katsumi
authors.initials: K
authors.lastname: Sasaki
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kurahashi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kaneko
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Akita
authors.forename: Nozomi
authors.initials: N
authors.lastname: Yoshikawa
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kusano
authors.forename: Toshiko
authors.initials: T
authors.lastname: Yamochi
authors.forename: Miki
authors.initials: M
authors.lastname: Kushima
authors.forename: Keiji
authors.initials: K
authors.lastname: Mitamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D001706:Biopsy; D002272:Carcinoembryonic Antigen; D018288:Carcinoma, Small Cell / Q000175:diagnosis* / Q000473:pathology; D053379:Chromogranin A; D002864:Chromogranins; D016099:Endoscopy, Gastrointestinal; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D010751:Phosphopyruvate Hydratase; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053379:Chromogranin A; D002864:Chromogranins; D010751:Phosphopyruvate Hydratase