右側腹部に転移をきたした胃内分泌細胞癌の１例

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  • A case of the neuroendocrine carcinoma of the stomach metastasizing to distant lymph node.

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We report a very rare case of neuroendocrine cacinoma metastasizing to a distant lymph node. An 81-year-old woman, was admitted to our hospital omplaining of epigastric dyscomfort. A Borrmann type 3 tumor occupying the anterior wall of the gastric antrum was found by gastrography and gastroendoscopic examination. Computed tomography (CT) revealed regional lymphnode metastasis, but no other obvious metastasis was observed. Distal gastrectomy with lymph node dessection was performed. Histologic findings of the resected tumor were consistent with a diagnosis of neuroendocrine carcinoma. The patient was discharged, however, and complained of a right lateral abdominal tumor about 18 months after gastrectomy. Abdominal ultrasonography, CT and Gallium scintigraphy revealed a malignant tumor on the right abdominal wall. The histological diagnosis with needle biopsy indicated metastatic neuroendocrine carcinoma. The tumor was dissected and histologic findings was confirmed metastatic neuroendocrine carcinoma in the lymph node. Tumor cells were stained positive by the chromogranin A and neuron-specific enolase on immunohistochemical staining, and electron microscopic examination showed neurosecrectory granules. Although the prognosis of this desease is very poor, the patient has survived without hepatic metastasis after dissection of the metastatic tumor. We describe our case of discriminating carcinoid with a review of the literature.

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