A Case of Large Cell Neuroendocrine Carcinoma of the Stomach with Long Remission after Postoperative Adjuvant Chemotherapy

Abstract

The patient was a 61-year-old man. Ten years after eradication of H. pylori (HP) in the stomach, esophagogastroduodenoscopy showed an ulcerative lesion in the great curvature against the gastric angle, and the tumor was diagnosed as gastric cancer using the biopsy specimens. The patient underwent a distal gastrectomy with D2-node dissection. Pathologically, the large tumor cells infiltrated the subserosa of the gastric wall, and these tumor cells immunohistochemically showed a positive reaction for chromogranin A and synaptophysin. Therefore, the tumor was diagnosed as large cell-neuroendocrine carcinoma of the stomach. Metastasis was observed in 4 regional lymph nodes, and the TNM classification was defined as pStage IIIA. After surgery, adjuvant chemotherapy consisting of 4 cycles of S-1 therapy following 6 courses of cisplatin (CDDP)/irinotecan (CPT-11) therapy was performed. The patient is well without any recurrence over 4 years after surgery. Adjuvant chemotherapy using CDDP/CPT-11 followed by S-1 is a treatment option for a possible therapeutic regimen. Furthermore, it is necessary to check the HP-eradicated stomach for detection of neuroendocrine carcinoma in the long term.