A CASE OF ENDOCRINE CELL CARCINOMA OF THE STOMACH WITH HYPERGASTRINEMIA AND NON TYPE A GASTRITIS

Abstract

A 66-year-old man was pointed out having two ulcerative lesions 1.5cm in diameter with crater in the upper body of the stomach by upper gastrointestinal series. Gastric endoscopy revealed submucosal tumorous lesions like dens molaris in morphology. With a biopsy, carcinoid tumor or poorly differentiated adenocarcinoma was diagnosed. Furthermore, negative response to anti-gastric wall cell antibody was disclosed and hypergastrinemia was associated. Total gastrectomy with lymph nodes dissection was performed. Histopathologically, endocrine cell carcinoma (mp, ly₃, v₂, n₁: stage II) in the background of non type A gastritis was diagnosed. The patient died of multiple hepatic metastasis one year and 8 months after the operation.
Endocrine cell carcinoma with hypergastrinemia like this case is rare. And macroscopic and histopathologic characteristics suggestive of classical carcinoid were also revealed in this case. This case is thought valuable in consideration for mechanisms of origin of endocrine cell carcinoma including the possibility of malignant change of carcinoid.