[Mixed exocrine-endocrine gastric carcinoma: a rarity of little consequence?].

HISTORY AND ADMISSION FINDINGS

A 38-year-old woman was admitted for the diagnosis of joint pains. She had no gastrointestinal symptoms.

INVESTIGATIONS

Barium contrast examination revealed a rigid gastric wall. Gastroscopy showed multifocal carcinoid (neuroendocrine) tumors, up to 3 mm in diameter, and a 2 cm tumor which had apparently not metastasised (as demonstrated by sonography and computed tomography), but had broken into the muscular layer.

TREATMENT AND COURSE

A partial gastrectomy and lymphadenectomies were performed. Histology showed a mixed exocrine-endocrine carcinoma with submucosal infiltration and lymph node metastases. The postoperative course was without complications.

CONCLUSION

Neuroendocrine tumors are rare diseases of the stomach for which therapeutic options are surgical resection or endoscopic removal. Tumors up to 1 cm diameter and concomitant type A gastritis, multiple endocrine neoplasms with infiltration or Zollinger-Ellison syndrome are removed endoscopically. Bigger tumors or tumors that have infiltrated the muscular layer are managed by partial gastrectomy In our opinion radical surgery is required in all carcinoids larger than 1 cm and other neuroendocrine tumors.