A Case of Simultaneous Gastric Large Cell Endocrine Carcinoma and Rectal Cancer

Abstract

A 76-year-old man was seen at a nearby clinic with a 2-week history of anorexia and vomiting. He came to our hospital because of a high CEA level. Abdominal computed tomography showed a tumor, 11 cm in diameter, centered on the dorsal aspect of the antral zone, and pancreatic invasion was suspected. Upper endoscopy showed that the tumor was mainly submucosal, and only necrotic tissue was found in the same site biopsy specimen. Colonoscopy showed rectal sigmoid carcinoma. It was decided to resect the stomach tumor because it was huge and obstructed. Pancreatoduodenectomy and colectomy were performed. The resected specimen showed large cell type gastric endocrine cell carcinoma with the findings of T3(SS)ly1v1N0, stage IIA. Three months after gastric surgery, anterior resection for rectal sigmoid carcinoma was performed with the findings of moderately differentiated tubular adenocarcinoma, T4(SS)ly1v1N0 in stage IIIa. Adjuvant chemotherapy with S1 was performed. Only one liver metastasis of rectal cancer occurred 1 year and 6 months after gastric surgery, so appropriate liver resection was performed. A rare case of simultaneous rectal cancer with gastric endocrine cell carcinoma was described.