Advanced gastric glandular-endocrine cell carcinoma with 1-year survival after gastrectomy

Matsubayashi, Hiroyuki; Takagaki, Shinichi; Otsubo, Takao; Iiri, Takao; Kobayashi, Yuka; Yokota, Takashi; Shichijo, Kimitoshi; Tada, Tetsuya; Satoh, Keiichi; Iwafuchi, Mitsuya

doi:10.1007/pl00011721

Cited by 21 publications

(17 citation statements)

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“…5D). These results correspond to the report that early gastric ECC is usually observed as a polypoid lesion arising from deep mucosa or submucosa, while later, a crater-like ulceration develops, most likely due to its rapid proliferation [1]. For this reason, finding an early ECC (such as T1 stage) may be very difficult compared to GC.…”

Section: Discussionsupporting

confidence: 55%

“…Extrapulmonary sites of ECC account for 4% of all cases [12], and, in particular, gastric ECC is extremely rare, accounting for 0.1%-0.2% of all gastric carcinomas [1][2][3][4]. We employ the term "endocrine cell carcinoma (ECC)", because the term "small" is not clearly defined in extrapulmonary lesions, and this neoplasm is believed to originate from endodermally derived stem cells [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Extrapulmonary small-cell carcinoma is rare in the gastrointestinal tract, accounting for about 1% of cancers in the esophagus, 0.2% in the colon, and 0.1%-0.4% in the stomach [1][2][3][4]. Extrapulmonary small-cell carcinoma has been variously termed "endocrine cell carcinoma (ECC)", "atypical carcinoid" [5], and "oat-cell carcinoma" [6].…”

Section: Introductionmentioning

confidence: 99%

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Advanced gastric endocrine cell carcinoma with distant lymph node metastasis: a case report and clinicopathological characteristics of the disease

et al. 2004

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tiation [7]. The prognosis of gastric ECC is extremely poor, and lymph node and liver metastases are observed frequently [7]. We hypothesized that lymphatic or blood vessels incur high rates of permeation even in the early stage of gastric ECC, and this results in the frequent lymph node and liver metastases. In this study, we report our treatment of a 75-year-old woman with pure ECC. We also analyzed characteristics of the clinicopathological findings of gastric ECC by reviewing cases previously reported in the literature, and comparing the clinicopathological findings (lymphatic permeation, blood vessel permeation, lymph node metastasis, and liver metastasis) with those of gastric carcinoma, using statistical analysis. Case reportA 75-year-old woman was referred to Mito Red Cross Hospital (Mito, Ibaraki, Japan) because of an abnormal gastric lesion first detected at a medical checkup in May 2002, at which time she had no symptoms. On admission, there was no enlargement of any superficial lymph nodes. Peripheral blood showed normal levels of all the basic biochemical parameters, and a slightly high level of the tumor marker, carcinoembryonic antigen (CEA; 6.0ng/ml; normal range Ͻ4.0ng/ml). Upper gastrointestinal radiograph revealed a mass with a central ulceration, surrounded by a smooth elevated area, and with a clear margin, in the lesser curvature close to the esophagogastric junction (EGJ) (Fig. 1A). Upper gastrointestinal endoscopic study showed a 2-cm mass with a deep central depression and surrounded by a smooth elevated area, findings which corresponded to the radiographic image (Fig. 1B). The mass lesion was suspected to be ECC, based on the results of immunohistochemical staining of biopsy samples being positive for CD10 and cytokeratin (Fig. 2). Chest radiography and computerized tomographic (CT) scan of the chest did not Abstract Gastric pure endocrine cell carcinoma (ECC) is extremely rare. ECC occasionally shows multidirectional differentiation; that is, adenocarcinomatous and/or squamous proliferation. Because gastric ECC has aggressive biological behavior and shows frequent metastasis to liver and lymph nodes even in the early stage, the prognosis of patients having this disease is extremely poor. We treated a 75-year-old woman with advanced gastric pure ECC with total gastrectomy and lymph node dissection, and reviewed all the previously reported cases of this disease. We compared the clinicopathological findings of ECC with those of gastric carcinoma (GC) and found that ECC had significantly more frequent invasion to lymphatic and vascular lumens (P < 0.01) and more frequent metastasis to lymph nodes (P < 0.01) and liver (P < 0.05) compared to GC. Gastric ECC smaller than 5 cm in the greatest dimension showed a higher percentage of advanced lesions (>T2) than GC (P < 0.05), which could result in the difficulty of finding early ECC. The findings of the analyses we made in this report may account for the poor prognosis of this disease.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Advanced gastric endocrine cell carcinoma with distant lymph node metastasis: a case report and clinicopathological characteristics of the disease

et al. 2004

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“…Gastric endocrine carcinoma (EC) is an uncommon tumor of the stomach and it has been reported that 0.1-0.6% of gastric cancers exhibit endocrine cell differentiation [1]. In general, the prognosis of patients with this tumor is extremely poor because gastric EC has aggressive biological behavior and frequently metastasizes to lymph nodes and the liver even in the early stages of the disease [2].…”

Section: Introductionmentioning

confidence: 99%

Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute

et al. 2012

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Background Gastric endocrine carcinoma (EC) is an uncommon tumor of the stomach and the clinical features are not well known. Additionally, the classification and staging systems of this tumor are not yet unified worldwide. In this study, we reviewed 27 patients with gastric EC to evaluate the clinicopathological characteristics of this tumor. Methods We retrospectively reviewed 27 patients with gastric EC among 6466 patients who had undergone gastrectomy between 1986 and 2008 at our institute. Clinicopathological features including immunohistochemistry of Ki-67 were investigated to evaluate the malignant potential of the tumor. Furthermore, survivals were compared between the 7th edition of the International Union Against Cancer (UICC)-TNM (7th TNM) classification for gastric cancer (GC) and the new TNM classification for foregut neuroendocrine tumors (NET). Results The median survival of the patients was 19.0 months. The 5-year survival rate was 100% in pathological stage (pStage) I, 40% in pStage II, 38% in pStage III, and 11% in pStage IV according to the 7th TNM classification for GC. Survivals by stage showed great difference between the 7th TNM classification for GC and the new TNM classification for foregut NET, but each system correlated with survival. The Ki-67 labeling index was more than 20% in most of the patients. Univariate analysis revealed that maximum tumor diameter, tumor depth, lymph node metastasis, lymphatic invasion, pStage, and curability had significant correlations with survival. Conclusion Early detection and curative operations are essential for improving the prognosis of gastric EC. However, some adjuvant chemotherapies are required for advanced-stage tumors. Classification and staging systems may need to be unified worldwide for further analysis.

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“…Since Matsusaka et al described this variant first in 1976, less than 230 cases have been reported in the literature [62]. This tumor also has been referred to "oat cell carcinoma" and "atypical carcinoid" and accounts for 0.1 -0.6% of total gastric cancers [63,64]. The mean age of presentation is 65 years (range, 42 to 84 years) and it commonly affects males [65].…”

Section: Neuroendocrine Cell Carcinomamentioning

confidence: 99%

Variants of Gastric Carcinoma: Morphologic and Theranostic Importance

Lee¹,

Kim²,

Ro³

2013

Gastric Carcinoma- New Insights Into Current Management

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Advanced gastric glandular-endocrine cell carcinoma with 1-year survival after gastrectomy

Cited by 21 publications

References 22 publications

Advanced gastric endocrine cell carcinoma with distant lymph node metastasis: a case report and clinicopathological characteristics of the disease

Advanced gastric endocrine cell carcinoma with distant lymph node metastasis: a case report and clinicopathological characteristics of the disease

Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute

Variants of Gastric Carcinoma: Morphologic and Theranostic Importance

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