Matsui T, Kataoka M, Sugita Y, Itoh T, Ichihara T, Horisawa M, Koide A, Ichihara S, Nakao A
Department of Surgery, Nagoya National Hospital.
Hepatogastroenterology. 1997 Jan-Feb;44(13):156-60.
A case of small cell carcinoma of the stomach is reported. A 53-year-old male was referred to our hospital for elective surgery for gastric cancer. Pre-operative examinations revealed no metastases. Gastrectomy was performed curatively, and there were no gross findings of metastases. Histologically, the tumor was composed of intermediate-sized cells with hyper-chromatic nuclei and scanty cytoplasm. These cells were argyrophilic and positive for chromogranin A. A small portion of the tumor consisted of conventional adenocarcinoma (signet ring cell carcinoma and tubular adenocarcinoma). No lymph node metastasis was observed microscopically. However, 7 months after the operation, splenic and hepatic metastases were detected, and the patient died very soon thereafter. Small cell carcinoma of the stomach is a very rare disease. In literature, only 15 cases have been cured surgically. Among them, only one case had been diagnosed as small cell carcinoma before the operation, which suggests the difficulty of pre-operative diagnosis. The prognosis of this disease is very poor compared with the common type of gastric carcinoma. Considering the poor prognosis of this particular disease, adjuvant chemotherapy might be mandatory in all cases even if surgically curative resection is performed.
报告了一例胃小细胞癌病例。一名53岁男性因择期胃癌手术转诊至我院。术前检查未发现转移。进行了根治性胃切除术，肉眼未发现转移灶。组织学上，肿瘤由中等大小的细胞组成，细胞核深染，细胞质稀少。这些细胞嗜银，嗜铬粒蛋白A呈阳性。肿瘤的一小部分由传统腺癌（印戒细胞癌和管状腺癌）组成。显微镜下未观察到淋巴结转移。然而，术后7个月，发现脾和肝转移，患者此后很快死亡。胃小细胞癌是一种非常罕见的疾病。在文献中，只有15例通过手术治愈。其中，只有1例在术前被诊断为小细胞癌，这表明术前诊断存在困难。与常见类型的胃癌相比，这种疾病的预后非常差。考虑到这种特殊疾病的预后较差，即使进行了手术根治性切除，所有病例都可能需要辅助化疗。
