Gastric neuroendocrine tumor treated with endoscopic submucosal dissection


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.

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  • 1. Bosman F.T., Carneiro, R., Hruban H., Theise N.D., editors (2010), WHO Classification of Tumours of the Digestive System 4th ed., Lyon: The International Agency for Research on Cancer.

  • 2. Cai Y.C. et al.: Cytokeratin 7 and 20 and thyroid transcription factor 1 can help distinguish pulmonary from gastrointestinal carcinoid and pancreatic endocrine tumors. Hum.Pathol., 32, 10, 2001.

  • 3. Erim T., Colak Y., Szomstein S.: Gastric carcinoid tumor after laparoscopic sleeve gastrectomy., Surgery for Obesity and Related Diseases, Volume 11, Issue 6, 2015.

  • 4. Jianu C.S. et al.: Gastric carcinoids after long-term use of a proton pump inhibitor. Aliment.Pharmacol. Ther., 36, 7, 2012.

  • 5. Kidd M., Gustafsson B., Modlin I.M.: Gastric carcinoids (neuroendocrine neoplasms). Gastroenterol.Clin. North. Am., 42, 2, 2013.

  • 6. Kwon Y.H. et al.: Long-term follow up of endoscopic resection for type 3 gastric NET. World J.Gastroenterol., 19, 46, 2013.

  • 7. Modlin I.M. et al.: Current status of gastrointestinal carcinoids. Gastroenterology. 128, 6, 2015.

  • 8. Muehldorfer SM et al.: Multicenter Study Group “Gastric Polyps”. Diagnostic accuracy of forceps biopsy versus polypectomy for gastric polyps: a prospective multicentre study. Gut, 50, 4, 2002.

  • 9. Park S.Y. et al.: Expression of cytokeratins 7 and 20 in primary carcinomas of the stomach and colorectum and their value in the differential diagnosis of metastatic carcinomas to the ovary. Hum. Pathol., 33, 11, 2002.

  • 10. Perryman S., Kaltenbach T., Eisenberg D.: Preoperative finding of gastric neuroendocrine tumor (gastric carcinoid) in a patient evaluated for bariatric surgery. Surgery for Obesity and Related Diseases, 7, 5, 2011.

  • 11. Ramage J.K. et al.: UK and Ireland Neuroendocrine Tumour Society. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut, 61, 1, 2012.

  • 12. Wang Z. et al.: Retrospective analysis of the clinicopathological characteristics of gastrointestinal neuroendocrine neoplasms. Exp. Ther. Med., 10, 3, 2015.

  • 13. Xu T.M. et al.: Clinicopathological features of primary gastric neuroendocrine neoplasms: A single-center analysis. J. Dig. Dis., 17, 3, 2016.


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