Neuroendocrine Carcinoma of the Stomach

ABSTRACT

PURPOSE: The aim of this study was to investigate the histopathologic characteristics and the clinical outcome of neuroendocrine carcinoma of the stomach. METHODS: The medical records of 16 patients diagnosed with neuroendocrine carcinoma between 1990 and 2001 at the Department of Surgery, Yonsei University College of Medicine were reviewed. RESULTS: There were 13 male and 3 female patients. The mean age at the time of diagnosis was 62.8 years. The presenting symptoms were epigastric pain or postprandial abdominal discomfort in ten patients, melena in two, and weight loss in one, the remaining three were diagnosed incidentally. Ten patients had a tumor in the upper or middle one third of the stomach and the remaining six patients had a tumor in the distal one third. The mean size of the tumor was 5.3 cm, ranging from 2 cm to 9 cm. The tumor extended beyond the serosa in ten patients (invading the pancreas in one patient), and was limited to the muscle layer proper in five patients, and to the submucosal layer in only one patient. Regional lymph node metastasis was noted in 11 patients. Tumor cells extended to the perigastric lymph nodes in 5 patients and the extra-perigastric lymph nodes in 6 patients, including paraaortic lymph nodes metastasis in 2 patients. Liver metastasis was present in one patient. Seven patients were alive without any evidence of recurrence at a mean follow-up of 75.7 months (range 9~125), and one other was alive with a recurrent disease in the peritoneal cavity. The remaining eight patients died of disease recurrence or progression at an average of 10.6 months after diagnosis. CONCLUSION: Neuroendocrine carcinoma of the stomach is more likely to develop in the male and is usually found at an advanced stage at the time of diagnosis. It also has a tendency to infiltrate deeply into the gastric wall with frequent regional lymph node metastasis. Neuroendocrine carcinoma is a peculiar histologic subtype of gastric cancer which takes an aggressive clinical course.