title: Primary gastric small cell carcinoma: report of a case and review of the literature.
abstract: A 52-year-old man suffering from a pure-type primary gastric small cell carcinoma was treated with surgery and combination chemotherapy. The small cell carcinoma, approximately 6.5 cm in diameter, was situated in the posterior wall of the antrum and there were no distant metastases. Total gastrectomy and regional lymph node dissection was carried out. Histological examination revealed a solid pattern of proliferation of small cells with hyperchromatic, round nuclei and scant cytoplasm. Neoplastic cells infiltrated into the subserosal layer with severe lymphatic and vascular invasion. Regional lymph node cells were mostly replaced by tumor cells that stained positive for Grimelius, neuron-specific enolase (NSE), and synaptophysin. Accumulations of electron-dense core granules in the small neoplastic cells were seen by electron microscopy. Following surgery, the patient was treated with adjuvant chemotherapy consisting of cisplatin and etoposide. The patient is alive and recurrence free 3 years after surgical operation. We review 107 published cases of primary gastric small cell carcinoma, an extremely rare disease first reported in 1976. Small cell carcinoma is an aggressive, malignant tumor. Intensive chemotherapy is essential for patient survival even when curative surgical resection is carried out.
authors.affiliation: Department of Tumor Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Takehiro
authors.initials: T
authors.lastname: Okabayashi
authors.forename: Shinzo
authors.initials: S
authors.lastname: Ozaki
authors.forename: Seiya
authors.initials: S
authors.lastname: Nakamura
authors.forename: Kuniyasu
authors.initials: K
authors.lastname: Yamashita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ueta
authors.forename: Junichi
authors.initials: J
authors.lastname: Miyazaki
authors.forename: Satoru
authors.initials: S
authors.lastname: Tamura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ohtsuki
authors.forename: Keijiro
authors.initials: K
authors.lastname: Araki
mesh_terms: D018288:Carcinoma, Small Cell / Q000473:pathology* / Q000628:therapy / Q000648:ultrastructure; D003593:Cytoplasm / Q000473:pathology / Q000648:ultrastructure; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy / Q000648:ultrastructure; D041742:Upper Gastrointestinal Tract / Q000000981:diagnostic imaging / Q000473:pathology