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Gastric Large-Cell Neuroendocrine Carcinoma Presenting as Perforation Peritonitis: a Rare Case Report

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Abstract

Gastric neuroendocrine carcinomas (GNECs) are rare tumors characterized by an aggressive clinical course, rapid progression, metastatic dissemination, and poor prognosis. Due to overlapping radiological features and small pre-operative biopsy specimens, they are frequently misdiagnosed as adenocarcinoma in the pre-operative period. These tumors are generally asymptomatic or present with non-specific symptoms like epigastric pain or discomfort, weight loss, and loss of appetite. However, GNECs presenting as perforation peritonitis are rarely reported in the literature. A 60-year-old man presented to the emergency department with complaints of pain upper abdomen with loss of weight and appetite for four months. He had an endoscopic biopsy report suggestive of antral growth reported as poorly differentiated adenocarcinoma. Radiological investigations were notable for the presence of a malignant lesion in the stomach with perforation. Subtotal gastrectomy with D1 lymph node resection was done. Specimen pathology confirmed poorly differentiated high grade large cell neuroendocrine carcinoma. This article emphasizes the importance of considering GNEC as a differential diagnosis for gastric adenocarcinoma despite overlapping radiological features and challenges with pre-operative diagnosis due to its aggressive nature and to allow for appropriate management.

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Data Availability

The data used to support the findings of this study are available from the corresponding author upon request. We will disclose all information except personal identifiable information.

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Authors and Affiliations

  1. Division of GI & HPB Surgery, Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research, 605006, Puducherry, India

    Ramnath Aishwarya, Ankit Jain, Souradeep Dutta, Reddy Abhinaya & Vishnu Prasad Nelamangala Ramakrishnaiah

  2. Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India

    Pampa Ch Toi

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Contributions

Draft preparation: Ramnath Aishwarya, Ankit Jain, and Souradeep Dutta. Data collection and analysis: Ramnath Aishwarya, Ankit Jain, and Pampa Ch Toi. Review and editing: Ankit Jain, Souradeep Dutta, Reddy Abhinaya, and Vishnu Prasad Nelamangala Ramakrishnaiah. Supervision: Vishnu Prasad Nelamangala Ramakrishnaiah. All authors contributed to the conceptualization and design of the case report. All authors have read and approved the manuscript.

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Correspondence to Vishnu Prasad Nelamangala Ramakrishnaiah.

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The need for approval was waived for a single case report.

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Written informed consent was obtained from the patient for participation in this case report study.

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Written informed consent was obtained from the patient for publication of this report and the accompanying images, and the patient’s anonymity was upheld.

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Aishwarya, R., Jain, A., Dutta, S. et al. Gastric Large-Cell Neuroendocrine Carcinoma Presenting as Perforation Peritonitis: a Rare Case Report. SN Compr. Clin. Med. 5, 141 (2023). https://doi.org/10.1007/s42399-023-01483-3

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