Abstract
Concurrence of adenocarcinoma and large-cell neuroendocrine carcinoma of the stomach is a rare condition. Here, we report a case of gastric collision tumour with large-cell neuroendocrine carcinoma and adenocarcinoma. A 71-year-old Peruvian man presented with nausea, epigastric pain, and weight loss for seven months. An Endoscopic evaluation revealed a huge ulcerative and infiltrative mass in the upper and middle third of the stomach. The patient underwent a D2 total gastrectomy. Microscopically, two separated and attached ulcerative lesions were recognised. The proximal to the cardial lesion showed neuroendocrine morphology and immunoreactivity for synaptophysin, and the other a moderated tubular adenocarcinoma Borrmann type III. Both lesions invaded serosa and lymph nodes metastases were found in 17 of 41 lymph nodes retrieved (one lymph node with neuroendocrine metastatic deposits).
Highlights
Adenocarcinomas are largely the most common gastric malignant tumour and concurrent or synchronous presentation in the same stomach of different histological type tumours rarely occurs
Lewin proposed a nomenclature for these neoplasms: (a) Composite tumours for the mixture of exocrine and endocrine components; (b) Collision tumours, where the exocrine and endocrine components differ and are juxtaposed and ; (c) Amphicrine cell tumours, where the endocrine and exocrine cells constituents are present within the same cell, exhibiting dual differentiation [1, 2]
We present a rare case of a gastric collision tumour displaying features of both large-cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma
Summary
Adenocarcinomas are largely the most common gastric malignant tumour and concurrent or synchronous presentation in the same stomach of different histological type tumours rarely occurs. We present a rare case of a gastric collision tumour displaying features of both large-cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma. The proximal one close to the cardial region measured 6.5 × 5.5 cm, with a whitish grey coloration and with an elastic consistency; and closely attached, a fungating ulcerative reddish lesion (Borrmann type III) measured 8.5 × 8.0 cm and occupied the posterior surface of the middle third of the stomach. The latter fixedly attached to the anterior surface of the body of the pancreas. Sections showed adenocarcinoma in all lymph nodes retrieved, but only one lymph node showed metastasis from the neuroendocrine carcinoma
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