Korean J Gastrointest Endosc.  2011 Apr;42(4):236-240.

A Case of Neuroendocrine Carcinoma Presenting as a Subepithelial Tumor Diagnosed by ESD

• Baek DH
• Kim SH
• Jung JY
• Son BK
• Jo Y
• Park YS
• Lee WM

Abstract

A gastric neuroendocrine carcinoma is very rare, and the histological diagnosis is very difficult. These carcinomas result in a poor prognosis because they are preceded by severe lymphovascular invasion and early metastasis. In particular, it is difficult to distinguish between adenocarcinoma and neuroendocrine carcinoma by endoscopy when no specific symptoms are present (e.g., dyspepsia, nausea). According to published articles in Korea, most cases were diagnosed as adenocarcinoma initially; however, they were confirmed postoperatively as neuroendocrine carcinoma based on a histological examination using immunohistochemical staining. A case of a 55-year-old man, who had an incidental finding of a subepithelial tumor during his health check-up, was recommended for an endoscopic submucosal dissection (ESD). But the patient was lost to follow-up for 4 years. When he was examined again, the size of the tumor had increased from the previous exam. He underwent ESD and was diagnosed with a well-differentiated neuroendocrine carcinoma.

Keyword

Carcinoma neuroendocrine; Subepithelial tumor; Endoscopic submucosal dissection

MeSH Terms

Adenocarcinoma
Carcinoma, Neuroendocrine
Dyspepsia
Endoscopy
Humans
Incidental Findings
Korea
Lost to Follow-Up
Middle Aged
Neoplasm Metastasis
Prognosis