Abstract
A 58-year-old man was admitted to our hospital because of an abnormal shadow of the stomach on barium meal at a medical check-up. Upper gastrointestinal endoscopy showed an ulcerated tumor at the greater curvature of the gastric antrum. It was diagnosed as gastric cancer (poorly differentiated adenocarcinoma) and distal gastrectomy was performed. Histopathological examination of the resected specimen showed tumor cells proliferating to the submucosal layer and the tumor was immunohistochemically positive for synaptophysin. Accordingly the tumor was diagnosed as early small cell carcinoma of the stomach. In addition, two lymph nodes with micrometastasis were revealed in the infrapyloric lymph node.
Gastric small cell carcinoma is rare and carries extremely poor prognosis due to the presence of vascular invasion or metastasis at an early stage. This case was of early gastric small cell carcinoma but micrometastasis of lymph node had already occurred. We need to recognize that even early gastric small cell carcinoma can already have micrometastasis.
