Liu Pengwei, Zhang Yan
Gastroenterology, The First Affiliated Hospital of Wannan Medical College, China.
Gastroenterology, The First Affiliated Hospital of Wannan Medical College.
Rev Esp Enferm Dig. 2025 Aug;117(8):479-481. doi: 10.17235/reed.2024.10933/2024.
Recently, mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) have attracted more attention. However, early gastric MiNEN is uncommon, and there are rare reports on the characteristics of it. As its clinical and endoscopic features are resemble to early gastric cancer (EGC), it can be easily misdiagnosed. The purpose of this article is to elaborate the endoscopic and pathological characteristics of early gastric MiNEN, which is of great significance for distinguishing it from EGC. A 67-year-old male patient underwent EGD revealing a 0-IIc+IIa lesion on the lesser curvature of the lower stomach body. The biopsy pathology indicated the lesion was an EGC. Endoscopic submucosal dissection (ESD) was subsequently applied to remove the lesion. According to postoperative pathological, the lesion was diagnosed as early MiNEN (tubular adenocarcinoma 50%, neuroendocrine carcinoma 50%), pT1b (submucosa 600 μm), pUL (1), Ly (0), v (1), pHM0, pVM0. And after that, surgical resection were added. A follow-up CT scan and endoscopy performed six months later revealed no metastasis or recurrence. This case highlights that early gastric MiNEN could mimic ECG. We deemed that ME-NBI combined with pathological biopsy could contribute to the identification of early gastric MiNEN.
近年来，混合性神经内分泌-非神经内分泌肿瘤（MiNENs）受到了更多关注。然而，早期胃MiNEN并不常见，关于其特征的报道也很少。由于其临床和内镜特征与早期胃癌（EGC）相似，很容易被误诊。本文旨在阐述早期胃MiNEN的内镜和病理特征，这对于将其与EGC区分开来具有重要意义。一名67岁男性患者接受了电子胃镜检查（EGD），发现胃体下部小弯处有一个0-IIc+IIa病变。活检病理显示该病变为EGC。随后进行了内镜下黏膜剥离术（ESD）以切除病变。根据术后病理，该病变被诊断为早期MiNEN（管状腺癌50%，神经内分泌癌50%），pT1b（黏膜下层600μm），pUL（1），Ly（0），v（1），pHM0，pVM0。之后又进行了手术切除。六个月后进行的随访CT扫描和内镜检查显示无转移或复发。该病例突出表明早期胃MiNEN可能会模仿EGC。我们认为，ME-NBI联合病理活检有助于早期胃MiNEN的识别。
