Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: STOMACH
Purpose: Endocrine cell carcinoma of the stomach has been reported rarely in the literature. A series of two such cases is described in this article.
Methods: Clinical and pathologic data were recorded and the literature was reviewed.
Results: One case was a 53-year-old male who had a type 2 like mass (Japanese classification) in the lesser curvature of the body of the stomach, with a suspicion of malignant lymphoma on preoperative endoscopic biopsy. Proximal gastrectomy was performed. Immunohistological staining of the resected specimen by chromogranin A revealed that the tumor was an endocrine carcinoma. The other case was a 65-year-old female who had a giant mass in the greater curvature of the antrum of the stomach with regional lymph node metastasis, who underwent subtotal gastrectomy. The preoperative diagnosis was again malignant lymphoma secondary to irregular lymphatic cell infiltration and lack of tubular structures. In this case, an endocrine carcinoma was confirmed by neuron specific enolase. Histological examination in both cases showed small to medium sized cells with scant cytoplasm, with irregular, small nuclei with abundant chromatin.
Conclusions: Endocrine cell tumors of the stomach are postulated to arise from pleuripotent stem cells and can coexist with other cell types, such as adenocarcinoma. Careful consideration of this etiology should be included in gastric cancers that appear to be poorly differentiated adenocarcinoma or malignant lymphoma, especially in lesions located submucosally.