A Case of Endocrine Cell Carcinoma and Adenocarcinoma of the Stomach in a Patient with Synchronous Multiple Cancers

Abstract

A case of endocrine cell carcinoma and adenocarcinoma of the stomach in a patient with synchronous multiple cancers is reported. An asymptomatic 66-year-old man was found on upper gastrointestinal endoscopy to have an ulcer and a depressed area with mucosal reddening. A biopsy showed poorly differentiated adenocarcinoma in both lesions. Abdominal CT showed no metastatic lesions in any organs. Multiple cancers, two tumors (one a type 3 cancer and the other a 0-IIa+IIc cancer), were diagnosed. The patient underwent total gastrectomy with Roux-en-Y reconstruction in April 2013. Histopathological findings showed that the histological type of the advanced cancer was endocrine cell carcinoma, with positive chromogranin A and synaptophysin staining, while the early gastric cancer was moderately differentiated tubular adenocarcinoma. The two tumors were unrelated. The patient was found to have tumor recurrence in the liver and thoracic spine six months after surgery. The patient was treated by chemotherapy, but he died eleven months after surgery.