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Neuroendocrine carcinoma of the stomach: clinicopathological and immunohistochemical evaluation

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Abstract

Neuroendocrine carcinoma (NEC) of the stomach is an uncommon disease. Because of its rarity, the clinicopathological features are unclear, and there is no consensus on the optimal treatment strategy. This study included five consecutive patients with gastric NEC who underwent surgery from July 2001 to August 2011. Clinical presentation, tumor location, tumor morphology and size, pathology and immunohistochemistry results, and treatment outcome were analyzed retrospectively and discussed. The study cohort of four men and one woman ranged in age from 52 to 84 years, with a median age of 72 years. Positive rates of neuroendocrine markers were 40 % for chromogranin A, 60 % for synaptophysin, 60 % for CD56, 40 % for neuron-specific enolase, and 100 % for p53 protein. Median number of lymph node metastases per patient was 10, with severe lymphatic and venous infiltration, and high Ki-67 labeling index (60–90 %) reported for all patients. Median tumor size was 6 cm. Stage IV disease was diagnosed in three patients; the other two patients showed stage IIIA tumors. After a mean follow-up of 29.8 months, two of the five patients had died of the disease. Although rare, gastric NECs deserve particular attention because of their strong malignant potential associated with an extremely poor prognosis. Such carcinomas demand an aggressive surgical approach followed by chemotherapy and multimodality adjuvant therapy.

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Acknowledgments

The authors thank Dr. Makoto Hiroi, Laboratory of Diagnostic Pathology, Kochi Medical School Hospital, Kochi, Japan, for diagnostic suggestions and technical assistance. No financial support was received for this study.

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Authors and Affiliations

  1. Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan

    Tsutomu Namikawa, Toyokazu Oki, Hiroyuki Kitagawa, Takehiro Okabayashi & Kazuhiro Hanazaki

  2. Department of Human Health and Medical Sciences, Kochi Medical School, Nankoku, Japan

    Michiya Kobayashi

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  1. Tsutomu Namikawa
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  2. Toyokazu Oki
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  3. Hiroyuki Kitagawa
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  6. Kazuhiro Hanazaki
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Correspondence to Tsutomu Namikawa.

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Namikawa, T., Oki, T., Kitagawa, H. et al. Neuroendocrine carcinoma of the stomach: clinicopathological and immunohistochemical evaluation. Med Mol Morphol 46, 34–40 (2013). https://doi.org/10.1007/s00795-012-0006-8

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  • DOI: https://doi.org/10.1007/s00795-012-0006-8

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