共存腺癌部でｃｈｒｏｍｏｇｒａｎｉｎ　Ａが認められた胃神経内分泌細胞癌の１例

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  • A CASE OF NEUROENDOCRINE CARCINOMA OF THE STOMACH CO-EXISTING WITH WELL-DIFFERENTIATED ADENOCARCINOMA THAT POSITIVELY STAINED WITH CHROMOGRANIN A

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A 63-year-old man was admitted to the hospital because of epigastralgia. Upper gastrointestinal endoscopic examination revealed a type 3 tumor in the lesser curvature of the upper corpus of the stomach, and microscopic study of the biopsy specimens led to an initial diagnosis of poorly differentiated adenocarcinoma. As no metastatic lesions were detected in any organ by preoperative abdominal CT scan, total gastrectomy with splenectomy and D2 lymph node dissection were performed. Histopathological examination revealed that the tumor was composed of dominant neuroendocrine carcinoma and well-differentiated tubular adenocarcinoma in the mucosa, and the both components were positive for chromogranin A on immunohistochemical study. Despite adjuvant chemotherapy with etoposide and cisplatin, the patient died of multiple liver metastases 6 months after the surgery. Neuroendocrine carcinoma of the stomach is a rare pathological type and has an extremely poor prognosis. This case is thought interesting from the standpoint of histogenesis of neuroendocrine carcinoma, because the coexisted well differentiated tubular adenocarcinoma also stained with chromogranin A.

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