title: Unusual case of small cell gastric carcinoma: case report and literature review.
abstract: BACKGROUND
  Small cell carcinomas are among the most aggressive, poorly differentiated, and highly malignant of the neuroendocrine tumors (NETs). Of which, small cell gastric carcinoma is a rare small cell neuroendocrine tumor. The purpose of our study was to present this case and perform a comprehensive literature review.
  
  
  RESULTS
  We review a case of small cell gastric carcinoma that is particularly unusual in that it occurred in a woman from the US when the majority of cases of small cell gastric carcinoma have been reported in men from East Asia, and more specifically, from Japan. The diagnosis was made after endoscopy revealed a large ulcerated mass in the gastric cardia of Borrmann type 3. Biopsies revealed multiple small basophilic cells underlying the squamous epithelium of the esophagus and cardiac mucosa, indicating the presence of a tumor at the gastroesophageal junction. Immunostaining established the diagnosis with positive stains for chromogranin, synaptophysin, and CD56. Our patient is being treated with chemotherapy, but many different treatment regimens have been tried for small cell gastric carcinoma with variable success.
  
  
  CONCLUSIONS
  Overall prognosis for small cell gastric carcinoma is dismal. Neuroendocrine tumors in general have variable clinical behaviors and prognosis is dependent on the neuroendocrine tumor type. The adoption of a standardized classification system for neuroendocrine tumors could improve the recognition of infrequently encountered neuroendocrine tumors like small cell gastric carcinoma and will enhance strategies for treatment and thus improve prognosis for patients with these rare and aggressive tumors.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Hepatology, and Nutrition, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA. David.Richards@uth.tmc.edu
authors.forename: David
authors.initials: D
authors.lastname: Richards
authors.forename: Daniel
authors.initials: D
authors.lastname: Davis
authors.forename: Peisha
authors.initials: P
authors.lastname: Yan
authors.forename: Sushovan
authors.initials: S
authors.lastname: Guha
mesh_terms: D015703:Antigens, CD / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D016190:Carboplatin / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D002864:Chromogranins / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004724:Endoscopy; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D016708:Synaptophysin / Q000032:analysis; D014213:Tretoquinol
chemical_list: D015703:Antigens, CD; D002864:Chromogranins; D007004:Hypoglycemic Agents; D016708:Synaptophysin; D005047:Etoposide; D016190:Carboplatin; D014213:Tretoquinol