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Case Reports
. 2015 Mar;100(3):562-7.
doi: 10.9738/INTSURG-D-14-00074.1.

A case of mixed adenoneuroendocrine carcinoma of the stomach with focal intestinal metaplasia and hypergastrinemia

Hayato Yamauchi  1 , Shinji Sakurai, Nobuhiro Nakazawa, Tomonori Yoshida, Yuichi Tabe, Kana Saitoh, Takaharu Fukasawa, Shinsuke Kiriyama, Hiroshi Naitoh, Hiroyuki Kuwano
Affiliations
Case Reports

A case of mixed adenoneuroendocrine carcinoma of the stomach with focal intestinal metaplasia and hypergastrinemia

Hayato Yamauchi et al. Int Surg. 2015 Mar.

Abstract

Among neuroendocrine neoplasms, mixed exocrine and endocrine characteristics with at least 30% of each component are classified into mixed adenoneuroendocrine carcinoma (MANEC), according to the 2010 World Health Organization classification. We experienced a rare case of MANEC of the stomach with focal intestinal metaplasia and hypergastrinemia. A 76-year-old Japanese male was diagnosed as having gastric adenocarcinoma and underwent total gastrectomy. The pathologic diagnosis was MANEC of the stomach accompanied by unusual mucosal atrophy without Helicobacter pylori infection, the characteristics of which were different from both type A and type B atrophic gastritis. The patient has a history of long-term use of a proton pump inhibitor. Additional serum chemistry examination using preoperatively obtained plasma from the patient revealed hypergastrinemia. The mechanism of gastric MANEC carcinogenesis is still unclear, but that might be correlated with unusual intestinal metaplasia and hypergastrinemia in this case.

Keywords: Hypergastrinemia; Intestinal metaplasia; Mixed adenoneuroendocrine carcinoma; Proton pump inhibitor; Stomach.

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Figures

Fig. 1
Fig. 1
The tumor cells composed of signet-ring cell carcinoma in the surface of the mucosal layer and of smaller cells located in the lower mucosal layer and the submucosal layer.
Fig. 2
Fig. 2
Synaptophysin (A) and chromogranin A (B) were expressed in the carcinoid-like tumor cells.
Fig. 3
Fig. 3
The hyperplasia of ECL cells positive for synaptophysin was observed in some gastric fundic glands close to the tumor.
Fig. 4
Fig. 4
ECMs were demonstrated at the fundic gland base and within the muscular layer of mucosa adjacent to carcinoma.
See this image and copyright information in PMC

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