A case of a 59-year-old male patient with gastric neuroendocrine tumor which was misdiagnosed as adenocarcinoma, is presented. Herein, primary diagnosis was made due to the similarity of endoscopic pictures of both diseases and dues to the inappropriate interpretation of a small biopsy sample. The patient was qualified for endoscopic submucosal dissection. Microscopic examination of whole lesion, supplemented by immmunohistochemical reactions (chromogranin A, synaptophysin, cytokeratins 7 and 20, Ki67) revealed gastric neuroendocrine tumor (NET) G2.
The lesson learnt is that to provide effective treatment to the patient, it is necessary to use all available methods to make a proper diagnosis and to distinguish the suspected disease from others with similar features.
Gastric lipomatosis is a condition characterized by the presence of multiple lipomas or diffuse mature adipose tissue infiltration within the gastric wall. The diffuse form is thought to be an extremely rare, with only few described cases. The lesion may be asymptomatic or associated with symptoms and signs depending on location and size. Treatment depends on clinical presentation, range and complications. In a symptomatic disease, it should be surgical, but conservative treatment is preferred for asymptomatic and solitary lesions. Among diagnostic methods, computed tomography and magnetic resonance imaging are thought to be the most valuable.