title: Gastric mixed adenoneuroendocrine carcinoma occurring 50 years after a gastroenterostomy with braun anastomosis.
abstract: A 75-year-old man was diagnosed with gastric cancer. Fifty years previously, he had undergone gastroenterostomy with a Braun enteroenterostomy. At present, a distal gastrectomy and small intestinal partial resection were performed. Intraoperatively, the tumor was localized to the previous stomal site. HE staining showed that the tumor comprised two elements: a tubular adenocarcinoma on the gastric side and a neuroendocrine carcinoma (NEC) on the jejunal side. The final pathologic diagnosis was mixed adenoneuroendocrine carcinoma based on an immunohistochemical analysis of endocrine markers and an elevated Ki-67 labeling index. The risk of later cancer development cancer recurrence near the gastrojejunostomy site is well known. Potentially, chronic enterogastric bile reflux may irritate the gastric mucosa and act as a promoter. Gastric NEC has a strong malignant potential. We suspect that, in the present case, the constant exposure to secondary bile may have induced a gastric mucosal adenocarcinoma, which finally differentiated into a NEC.
authors.affiliation: Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nemoto
authors.affiliation: Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Genshu
authors.initials: G
authors.lastname: Tate
authors.affiliation: Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Yokomizo
authors.affiliation: Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Umemoto
authors.affiliation: Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Taketo
authors.initials: T
authors.lastname: Matsubara
authors.affiliation: Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mizukami
authors.affiliation: Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Gaku
authors.initials: G
authors.lastname: Kigawa
authors.affiliation: Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumiya
authors.affiliation: Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Tanaka
keywords: Braun enteroenterostomy; Gastroenterostomy; Mixed adenoneuroendocrine carcinoma; Neuroendocrine carcinoma