Abstract
A 78-year-old man was referred to the hospital because of epigastralgia. Gastric endoscopy revealed an elevated lesion at the upper portion and another elevated lesion at the antrum of the stomach, of which biopsies indicated poorly differentiated adenocarcinoma and well differentiated adenocarcinoma at the upper portion and at the antrum, respectively. The depth of tumor invasion was determined to be shallower than MP in both lesions. An abdominal CT scan revealed no metastases to the other sites as well as lymph nodes, but did the presence of gallstone. Multiple gastric cancer and gallbladder stone were diagnosed, and laparoscopic-assisted total gastrectomy, D2 dissection, and cholecystectomy were performed. Histopathological diagnosis of the lesion at the upper portion of the stomach was small cell carcinoma of the stomach because the tumor cells were positive for CD56, synaptophysin, and chromogranin A ; and that of the antrum lesion was well differentiated adenocarcinoma. The gallbladder lesion was well differentiated adenocarcinoma. His postoperative course was uneventful and he was discharged from the hospital on the 23rd day after the operation.
Small cell carcinomas of the stomach reportedly account for about 0.06%-0.2% of all gastric cancers. Furthermore, multiple occurrence of this malignancy has been reported in only eight cases, including those of multiple cancers in the same organ. The prognosis of such patients might be determined by the progress of small cell carcinoma of the stomach, though influence of the associated malignancy could not be neglected.
