2017 Volume 59 Issue 12 Pages 2712-2718
A 73-year-old woman complaining of epigastralgia was diagnosed as having a huge tumor at the upper body of the stomach on upper gastrointestinal series performed at another hospital and was referred to our hospital. Gastroscopy revealed a huge type 1 tumor of 8cm in diameter located in the posterior wall of the upper area of the body of the stomach and a type 0-Ⅱ tumor of 2cm in diameter located in the anterior wall of the gastric fornix. The two tumors were unrelated. Pathological examination of the biopsy specimens showed that the huge tumor was neuroendocrine carcinoma (NEC) and the second tumor was moderately differentiated adenocarcinoma. Proximal gastrectomy and splenectomy were performed. The postoperative pathological diagnoses from examination of the resected tumors were the same as the diagnoses obtained by examination of the preoperative biopsy specimens. Postoperative adjuvant chemotherapy with S-1 + CDDP was administered. Although gastric NEC is rare with a poor prognosis, this patient has been well with no recurrence for six years. A case with accurate preoperative diagnosis of synchronous multiple gastric cancers of NEC and adenocarcinoma has not been previously reported in Japan.
