Primary gastric endocrine cell carcinoma (ECC) is extremely rare. In general, when it is advanced, gastric ECC causes extensive ulceration (type 2) and invades or metastasizes to other organs, frequently to the liver and sometimes to the lungs or bones, and carries a poor prognosis. We herein report a 67-year-old man with advanced gastric ECC of extensive-polypoid shape (type 1) but without distant metastasis, who underwent total gastrectomy and treatment with oral tegafur-uracil (UFT), and showed no sign of recurrence 1 year later.

An 82-year-old man was admitted to hospital with symptoms of abdominal fullness and loss of appetite. Abdominal computed tomography (CT) scan and ultrasonography showed enlargement of the whole pancreas with para-aortic lymphadenopathy. Endoscopic retrograde pancreatography (ERP) showed diffuse narrowing of the main pancreatic duct (MPD), and brushing cytology from the MPD was non-neoplastic. Differential diagnosis between lymphoma and other exocrine and endocrine pancreatic malignancies was needed, and the level of serum soluble interleukin-2 receptor (17 751 U/ml) was revealed to be significantly high, which was strongly suggestive of pancreatic lymphoma. Chemotherapy was refused by the patient's family and the patient succumbed after 2 months of conservative follow-up. Autopsy revealed diffuse, mixed cell-type, non-Hodgkin's lymphoma of T-cell subtype.

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