Kaneko H, Miyake A, Ishii Y, Sue S, Miwa H, Sasaki T, Tamura T, Kondo M, Maeda S. Case of a tumor comprising gastric cancer and duodenal neuroendocrine tumor. World J Gastroenterol 2016; 22(36): 8242-8246 [PMID: 27688667 DOI: 10.3748/wjg.v22.i36.8242]
Corresponding Author of This Article
Shin Maeda, MD, PhD, Department of Gastroenterology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura Kanazawa-ku, Yokohama 236-0004, Japan. smaeda@yokohama-cu.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hiroaki Kaneko, Yasuaki Ishii, Soichiro Sue, Haruo Miwa, Tomohiko Sasaki, Toshihide Tamura, Masaaki Kondo, Shin Maeda, Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
Akio Miyake, Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
Author contributions: Kaneko H performed the majority of experiments and wrote the manuscript; Miyake A was in charge of the pathological diagnosis; Ishii Y, Sue S, Miwa H, Sasaki T, Tamura T and Kondo M participated to the medical care of the patient; Maeda S served as scientific advisor and participated to the medical care of the patient.
Institutional review board statement: This case report was approved by the ethics committee of Yokohama City University Graduate School of Medicine.
Informed consent statement: All study participants provided informed written consent prior to the treatment.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shin Maeda, MD, PhD, Department of Gastroenterology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura Kanazawa-ku, Yokohama 236-0004, Japan. smaeda@yokohama-cu.ac.jp
Telephone: +81-45-7872326 Fax: +81-45-7872327
Received: March 11, 2016 Peer-review started: March 12, 2016 First decision: April 14, 2016 Revised: April 20, 2016 Accepted: June 13, 2016 Article in press: June 13, 2016 Published online: September 28, 2016
Abstract
The present report describes a rare case of a tumor composed of early gastric cancer and a duodenal neuroendocrine tumor (NET). A 78-year-old woman underwent esophagogastroduodenoscopy at a local institution for screening of the upper gastrointestinal tract which revealed a protruded tumor through the pyloric ring from the pyloric antrum. The tumor was too large to treat at the facility; consequently, she was referred to our hospital for further management. Esophagogastroduodenoscopy with tumor biopsy of the lesion revealed the diagnosis of early gastric cancer. Endoscopic submucosal dissection was performed with sufficient free margins in both vertical and horizontal directions. Histopathological findings showed NET confined to the submucosal layer and covered by well-differentiated adenocarcinoma. Immunohistochemical stainings showed that the two lesions existed continuously. While the possibility of a collision cancer was considered, it was suggested that the two lesions existed continuously. Finally, the tumor was diagnosed as gastric cancer composed of duodenal NET G1, with a lymphatic invasion of NET component.
Core tip: Although there are some reports of endoscopic resection performed to duodenal neuroendocrine tumor (NET), no reports have been published on the treatment of duodenal NET composed of early gastric cancer treated by endoscopic submucosal dissection (ESD). A 78-year-old woman underwent esophagogastroduodenoscopy and revealed a protruded tumor through the pyloric ring from the pyloric antrum. ESD was performed and finally the tumor was diagnosed as gastric cancer composed of duodenal NET G1, with a lymphatic invasion of NET component. We report the first case of early gastric cancer accompanied by duodenal NET, which was resected by ESD.
