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[1例胃腺癌化疗期间经扩大的原发肿瘤再次活检诊断的混合性神经内分泌-非神经内分泌肿瘤(MiNEN)]

[A case of mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) diagnosed by re-biopsy of the enlarged primary tumor during chemotherapy for gastric adenocarcinoma].

作者信息

Fuchino Mayo, Nakaya Atsuko, Ando Takayuki, Hasumoto Yuushi, Ozawa Koji, Ito Hiroyuki, Yabushita Kazuhisa, Miwa Shigeharu, Hayashi Shinichi

机构信息

Department of Gastroenterology, Takaoka City Hospital.

Third Department of Internal Medicine, University of Toyama.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2024;121(1):55-62. doi: 10.11405/nisshoshi.121.55.

Abstract

Gastric mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is an extremely rare form of gastric neoplasm, and its prognosis is often poor. This is a case report wherein the primary site increased during chemotherapy against gastric adenocarcinoma and was diagnosed with gastric MiNEN after total gastrectomy. A 71-year-old man was diagnosed with gastric adenocarcinoma complicated with liver and para-aortic lymph node metastasis. Chemotherapy with S-1, oxaliplatin, and trastuzumab was initiated. Although the size of metastatic lesions was reduced after six courses of treatment, a part of the primary site of gastric tumor rapidly. Pathological rebiopsy of the primary site suggested a neuroendocrine carcinoma, and he was finally diagnosed with gastric MiNEN after total gastrectomy. Thus, second-line chemotherapy was then initiated showing good response. We herein report a case of MiNEN with a rare diagnostic process.

摘要

胃混合性神经内分泌-非神经内分泌肿瘤(MiNEN)是一种极其罕见的胃肿瘤形式,其预后通常较差。本文报告一例在针对胃腺癌的化疗过程中原发部位增大,全胃切除术后被诊断为胃MiNEN的病例。一名71岁男性被诊断为胃腺癌合并肝及腹主动脉旁淋巴结转移。开始使用S-1、奥沙利铂和曲妥珠单抗进行化疗。虽然经过六个疗程的治疗后转移灶大小缩小,但胃肿瘤原发部位的一部分迅速增大。对原发部位进行病理再次活检提示为神经内分泌癌,全胃切除术后最终诊断为胃MiNEN。因此,随后开始二线化疗,显示出良好的反应。我们在此报告一例诊断过程罕见的MiNEN病例。

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