An endocrine cell carcinoma with gastric-and-intestinal mixed phenotype adenocarcinoma component in the stomach.
A 77-year-old man complained of bodyweight loss, and a Borrmann 3 type lesion was observed endoscopically in the anterior wall of angular region of the stomach. The endocrine cell carcinoma (ECC) having the cytoplasmic staining of chromogranin A (CgA) was detected pathologically in the biopsy samples. The patient underwent distal gastrectomy plus systemic lymph node (LN) dissection (D2 LN dissection), and pathological examination revealed ECC invading the subserosa, and no LN metastasis (pT2N0M0). None of the gastric and intestinal endocrine cell marker expression was apparent in the ECC cells. The lesion also contained a moderately differentiated type tubular adenocarcinoma component, which was judged to be gastric-and-intestinal mixed (GI type) phenotype, using gastric and intestinal exocrine cell markers. After the surgery, he left the hospital and started oral doxifluridine (600 mg/day). The patient now (March 2008, about 19 months since the surgery) continues this chemotherapy with no recurrence. In conclusion, we experienced ECC with a GI type adenocarcinoma component. The ECC cases with the GI type adenocarcinoma component may have a relatively good prognosis, being similar to the results of advanced gastric cancers from the viewpoint of gastric and intestinal phenotypic expression.
Mizoshita
Tsutomu
T
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Japan.
Kataoka
Hiromi
H
Kubota
Eiji
E
Shimura
Takaya
T
Mori
Yoshinori
Y
Wada
Tsuneya
T
Ogasawara
Naotaka
N
Sasaki
Makoto
M
Kamiya
Takeshi
T
Sakamoto
Masaki
M
Akamo
Yoshimi
Y
Joh
Takashi
T
D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D004724:Endoscopy; D019858:Enteroendocrine Cells / Q000473:pathology*; D006801:Humans; D008297:Male; D018198:Mixed Tumor, Malignant / Q000473:pathology* / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery