Clinical characteristics of early neuroendocrine carcinoma in stomach: A case report and review of literature

Abstract

Introduction: Gastric neuroendocrine carcinoma (NEC) is rare. It is considered to be aggressive and has a poor prognosis since the diagnosis is usually made at its advanced stage. However, the survival rate is increased in some early gastric NECs. This study showed a case and reviewed the clinical characteristics of early NECs in stomach. Patient concerns: A 38-year-old man displayed no symptoms and underwent the gastric endoscopy test for his health examination, which showed a red slightly depressed lesion 1.0cm in size on the lesser curvature of gastric cardia. Magnifying endoscopy with narrow-band imaging (NBI) revealed a clear demarcation and an irregular mesh in vessels within the depressed area. The background mucosa was negative for atrophic gastritis and Helicobacter Pylori infection. A contrast-enhanced computed tomography (CT) scan disclosed no obvious thickening of stomach and lymphadenopathy. Blood tests and physical examination were unremarkable. He had not received any surgical treatment and denied a family history of cancer and any genetic disorders. The pathologic result of biopsy from the lesion was suspicious of superficial carcinoma. Then endoscopic submucosal dissection (ESD) was performed. Diagnosis: Gastric NEC G3 in the early stage (T1aN0M0). Interventions: Concerning this patient's situation, we considered the ESD as a curable treatment. And no radical surgery or adjuvant chemotherapy was arranged. Outcomes: The patient is doing well and displays no recurrence for 11months, who is still in follow-up. Lessonssubsectionsasperstyle: The early diagnosis and effective treatment by endoscopy would contribute to improve the prognosis of gastric NECs. Abbreviations: AC = adenocarcinoma, CgA = chromogranin A, CT = computed tomography, ECL = enterochromaffin-like, ESD = endoscopic submucosal dissection, FDG-PET = fluorodeoxyglucose-positron emission tomography, GEP-NEN = gastroenteropancreatic neuroendocrine neoplasm, MANEC = mixed adenoneuroendocrine carcinoma, NBI = narrow-band imaging, NEC = neuroendocrine carcinoma, NET = neuroendocrine tumor, SRS = somatostatin receptor scintigraphy, Syn = synaptophysin, WHO = World Health Organization, ZES = Zollinger-Ellison syndrome.