Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2015; 21(16): 5099-5104
Published online Apr 28, 2015. doi: 10.3748/wjg.v21.i16.5099
Oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor: A case report
Tae-In Lee, Jae-Young Jang, Seungmin Kim, Jung-Wook Kim, Young-Woon Chang, Youn-Wha Kim
Tae-In Lee, Jae-Young Jang, Seungmin Kim, Jung-Wook Kim, Young-Woon Chang, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 136-705, South Korea
Youn-Wha Kim, Department of Pathology, College of Medicine, Kyung Hee University, Seoul 136-705, South Korea
Author contributions: Lee TI and Jang JY designed the report; Jang JY was the patient’s attending doctor; Kim S, Kim JW and Chang YW organized the report; Kim YW performed the pathologic examinations; Lee TI wrote the paper.
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: Jae-Young Jang, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, South Korea. jyjang@khu.ac.kr
Telephone: +82-2-9588200 Fax: +82-2-9681848
Received: September 23, 2014
Peer-review started: September 23, 2014
First decision: October 14, 2014
Revised: November 17, 2014
Accepted: January 16, 2015
Article in press: January 16, 2015
Published online: April 28, 2015
Abstract

Gastric adenocarcinoma is one of the most common malignancies worldwide. Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical and pathologic features. A new and rare variant of gastric adenocarcinoma with chief cell differentiation (GA-CCD) has recently been recognized. Studies reporting the distinct clinicopathologic characteristics proposed the term oxyntic gland polyp/adenoma because of the benign nature of the GA-CCD. Typically, GA-CCD is a solitary mucosal lesion that develops either in the gastric cardia or fundus. Histologically, this lesion is characterized by tightly clustered glands and anastomosing cords of chief cells. Immunohistochemically, GA-CCD is diffusely positive for mucin (MUC) 6 and negative for MUC2 and MUC5AC. However, other gastric tumors such as a gastric neuroendocrine tumor or fundic gland polyp have been difficult to exclude. Because GA-CCD tends to be endoscopically misdiagnosed as a neuroendocrine tumor or fundic gland polyp, comprehensive assessment and observation by an endoscopist are strongly recommended. Herein, we report a rare case of oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor that was successfully removed by endoscopic mucosal resection.

Keywords: Chief cell differentiation, Gastric carcinoma, Mucin 6, Neuroendocrine tumor, Oxyntic gland adenoma

Core tip: Gastric adenocarcinoma with chief cell differentiation is a new and rare variant of gastric adenocarcinoma. Due to difficulty in ruling out other gastric tumors, such as gastric neuroendocrine tumor, fundic gland polyp, or gastric adenoma, comprehensive examination and observation by an endoscopist are strongly recommended. We report a rare case of oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor that was successfully removed by endoscopic mucosal resection.