Abstract
A 73-year-old man was referred to our hospital for evaluation of dizziness and gasping. Gastrofiberscopic examination revealed a prolapsed hemorrhagic tumor in the upper portion of the stomach. Biopsy of the lesion revealed a poorly differentiated adenocarcinoma. Computed tomography revealed invasion into the muscularis propria of the stomach. Total gastrectomy and lymphadenectomy were performed. The resected specimen of the prolapsed tumor had a maximum diameter of 20 mm, and pathologic evaluation yielded a diagnosis of an unmixed large cell endocrine carcinoma. The tumor invaded the submucosal layer of the stomach, but regional lymph node metastases were not observed. Immunohistochemistry revealed diffuse staining for chromogranin A and partial staining for CD56. The MIB-1 labeling index was greater than 20%. As gastric unmixed large cell endocrine carcinomas are very uncommon, we report this case along with a review of the literature.
