Early gastric mixed neuroendocrine-non-neuroendocrine neoplasms with endoscopic findings of neuroendocrine cell carcinoma components exposed on the mucosal surface: a case report

J Med Case Rep. 2022 Nov 14;16(1):416. doi: 10.1186/s13256-022-03657-4.

Abstract

Background: Gastric mixed neuroendocrine-non-neuroendocrine neoplasms are rare malignant tumors. The lack of specific findings makes it difficult to diagnose endoscopically. We report the case of early gastric mixed neuroendocrine-non-neuroendocrine neoplasms treated by endoscopic submucosal dissection.

Case presentation: An 81-year-old Japanese female underwent esophagogastroduodenoscopy for screening and was treated with endoscopic submucosal dissection for the diagnosis of early gastric cancer. Histopathologically, the lesion was diagnosed as mixed neuroendocrine-non-neuroendocrine neoplasms (tubular adenocarcinoma 2 60%, endocrine cell carcinoma 40%), pT1b(submucosa (SM) 900 μm), pUL(-), Ly(+), v(-), pHM0, pVM0. After additional surgical resection without adjuvant chemotherapy, she has had no recurrences or metastases for 3 years.

Conclusions: Comparing narrow-band imaging magnified endoscopic findings with pathological findings, the depressed area with a lack of surface structure was consistent with the neuroendocrine cell carcinoma component, while narrow-band imaging magnification findings showed non-network vessels. In this case, we examined endoscopic findings of early stage mixed neuroendocrine-non-neuroendocrine neoplasms in detail and compared it with the pathological findings. We believe that these endoscopic findings contribute to the diagnosis of mixed neuroendocrine-non-neuroendocrine neoplasms and can lead to its early detection.

Keywords: ESD; Early gastric cancer; MANEC; MiNENs.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma* / pathology
  • Aged, 80 and over
  • Carcinoma, Neuroendocrine* / pathology
  • Endoscopic Mucosal Resection* / methods
  • Female
  • Gastric Mucosa / pathology
  • Humans
  • Neuroendocrine Cells* / pathology
  • Neuroendocrine Tumors* / pathology
  • Stomach Neoplasms* / pathology