Yasuda Kazuhiro, Inokuchi Shoichi, Tsutsumi Satoshi, Takayama Hiroomi, Ikebe Masahiko, Bandou Toshio, Utsunomiya Tohru, Urabe Shogo
Department of Surgery, Oita Prefectural Hospital, 8-1 Bunyo, Oita, 870-8511, Japan.
Department of Pathology, Oita Prefectural Hospital, Oita, Japan.
Clin J Gastroenterol. 2025 May 1. doi: 10.1007/s12328-025-02139-6.
Gastric mixed neuroendocrine-non-neuroendocrine neoplasm, which consists of both exocrine and endocrine components, is rare and exhibits aggressive biological behavior and poor prognosis. A 64-year-old man underwent investigation for abdominal pain. An endoscopic examination revealed a 30-mm protruded lesion in the gastric antrum for which distal gastrectomy with lymph node dissection was performed. Histopathological examination showed two distinct components, an adenocarcinoma component and neuroendocrine carcinoma component, with immunohistochemical staining positive for CD56, chromogranin A, and synaptophysin. The final diagnosis was mixed neuroendocrine-non-neuroendocrine neoplasm, pT2, pN3, M0, stage IIIA. Multiple liver metastases were detected 3 months after surgery. The patient received irinotecan plus cisplatin therapy, which was effective, and the liver metastases disappeared. The patient remains alive, without any recurrence, more than 10 years after surgery. We present a rare case of gastric mixed neuroendocrine-non-neuroendocrine neoplasm and review the literature to contribute to improving our understanding of this kind of tumor.
胃混合性神经内分泌-非神经内分泌肿瘤由外分泌和内分泌成分组成，较为罕见，具有侵袭性生物学行为且预后较差。一名64岁男性因腹痛接受检查。内镜检查发现胃窦有一个30毫米的突出病变，遂行远端胃切除术及淋巴结清扫术。组织病理学检查显示有两种不同成分，即腺癌成分和神经内分泌癌成分，免疫组化染色显示CD56、嗜铬粒蛋白A和突触素呈阳性。最终诊断为混合性神经内分泌-非神经内分泌肿瘤，pT2，pN3，M0，ⅢA期。术后3个月检测到多发肝转移。患者接受了伊立替康联合顺铂治疗，治疗有效，肝转移消失。患者术后存活超过10年，无任何复发。我们报告一例罕见的胃混合性神经内分泌-非神经内分泌肿瘤病例，并回顾文献以增进我们对这类肿瘤的认识。
