A Case of Gastric Neuroendocrine Carcinoma Presenting as Panperitonitis by Stomach Perforation

ABSTRACT

Gastric neuroendocrine carcinoma is a rare cause of gastric malignant tumors and has a poor prognosis. The carcinoma has histologic features characterized by irregular shape, thick cords and trabeculae of tumor cells. Immunohistochemical staining of tumor cells shows synaptophysin as positive. We report a case of neuroendocrine carcinoma of the stomach initially presenting as panperitonitis because of spontaneous tumor perforation. A 70-year-old man visited our emergency room because of abdominal pain. A preoperative abdominal CT showed a pneumoperitoneum in the upper abdomen suggesting ulcer perforation of the stomach. An emergent laparotomy with primary repair of the perforation was performed. After general conditions of the patient improved, endoscopic biopsy was performed. Pathologic examination revealed that the tumor was a gastric neuroendocrine carcinoma. Radical subtotal gastrectomy was additionaly performed.