title: Minute gastric carcinoid tumor with regional lymph node metastasis.
abstract: We report a patient with a minute gastric carcinoid tumor with lymph node metastasis, and a small gastric cancer. A 50-year-old man having a diagnosis of an elevated lesion on the anterior wall of the gastric body, detected by a series of upper gastrointestinal examinations, was referred to the Cancer Institute Hospital. Careful upper fluoroscopy disclosed a small superficial depressed lesion with converging folds and a superficial elevated lesion covered with nonspecific gastric mucosa. With a final preoperative diagnosis of depressed early cancer and minute carcinoid tumor of the stomach, made by upper gastrointestinal examinations including biopsy, the patient underwent segmental gastrectomy and perigastric lymph node dissection. Histological examination of the resected specimen revealed a lymph node metastasis from a gastric carcinoid tumor of 5-mm diameter, in addition to an early gastric cancer of poorly differentiated adenocarcinoma. Small gastric carcinoid tumors have been regarded as being benign neoplasms biologically. However, the case we present suggests that attention should be paid to the possibility of metastasis at the time of treatment for a minute sporadic gastric carcinoid tumor. We therefore discuss the malignant potential of these tumors, mainly from the viewpoint of histopathological classification, to gain understanding so that the patients can be treated adequately.
authors.affiliation: Department of Gastrointestinal Surgery, Cancer Institute Hospital, 1-37-1 Kamiikebukuro, Toshima-ku, 170-8455, Tokyo, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shinohara
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Ohyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Nagano
authors.forename: Nozomi
authors.initials: N
authors.lastname: Amaoka
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Ohta
authors.forename: Toshiki
authors.initials: T
authors.lastname: Matsubara
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
authors.forename: Yo
authors.initials: Y
authors.lastname: Kato
authors.forename: Tetsuichiro
authors.initials: T
authors.lastname: Muto
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D001706:Biopsy; D002276:Carcinoid Tumor / Q000473:pathology* / Q000601:surgery; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery