Successful Surgical Resection of a Solitary Liver Metastasis from Gastric Neuroendocrine Carcinoma—A Case Report—

Abstract

A rare case of gastric neuroendocrine carcinoma (NEC) successfully controlled by surgical treatment alone is reported. A 74-year-old man undergoing hemodialysis was incidentally diagnosed with a gastric NEC during preoperative evaluation for cholecystectomy. No metastasis was found, and laparoscopic distal gastrectomy with lymphadenectomy was performed. The pathological diagnosis was gastric large-cell NEC, T3N0M0, Stage II A. The patient was followed without adjuvant chemotherapy due to renal dysfunction. Nine months later, serum CEA levels increased, and imaging showed a solitary liver metastasis in segment 5. Chemotherapy was considered unsuitable, but since the lesion remained solitary after one month of observation, and liver function was adequate, partial hepatectomy was performed. The patient's postoperative course was uneventful, and he was discharged home. To date, without any chemotherapy, the patient remains disease-free, 2 years and 4 months after gastrectomy and 1 year and 3 months after hepatectomy. Although multimodal treatment has been recommended for NECs in previous reports, this is a novel case demonstrating long-term disease control with surgery alone.