A case of early small cell carcinoma of the remnant stomach

Abstract

We experienced a case of early small cell carcinoma of the remnant stomach. A man in his later half of eighties was seen at the hospital because of upper abdominal discomfort and was found to have a type 0-IIa+IIc lesion like a submucosal tumor in the posterior wall of the lesser curvature of the remnant stomach reconstructed by Billroth-II method by an upper gastrointestinal endoscopy. The lesion was bulging in a gradual slope, and was covered with normal mucosa except the concave center. Immunohistochemically the biopsied tissue was strongly positive for CD56 and slightly positive for Chromogranin A and Synaptophysin, and then small cell carcinoma of the remnant stomach was diagnosed. Total removal of the remnant stomach, D1+βlymph node dissection and R-Y reconstruction were thus performed. The tumor showed sheet-like, honeycomb and trabecular arrangement of atypical cells which were oval-shaped and lacked in cytoplasm, and had infiltrated into the submucosal layer. Metastasis to lymph nodes of the group I was noted.
Small cell carcinoma of the stomach is a relatively rare histological type. It metastasizes to the lymph nodes and the liver in an early stage, showing a potent malignant potential. In this case, an endoscopic study performed 10 months earlier had already revealed a submucosal tumor like lesion in an early stage that might be an evidence of rapid enlargement of small cell carcinoma of the stomach.