Rapidly progressed large cell neuroendocrine carcinoma of the stomach with an increased serum alpha fetoprotein level: a case report

  • Koji TakahashiEmail author
  • Takeshi Nihei
  • Yohei Aoki
  • Naoaki Konno
  • Miyuki Nakagawa
  • Akari Munakata
  • Ken Okawara
  • Haruo Ohtani
  • Hiroshi Kashimura
Case Report


An 82-year-old man who had multiple hepatic tumors, a gastric tumor, and ascites was referred to our hospital. On the time of our hospital visit, he had a high serum alpha fetoprotein (AFP) level of 1206 ng/mL. Upper gastrointestinal endoscopy revealed a Borrmann Type II gastric tumor approximately 40 mm in diameter in the lesser curvature of cardia, and forceps biopsy was performed. Endoscopic ultrasound fine-needle aspiration was also performed for hepatic tumor. The biopsy specimens from the gastric and hepatic tumor were diagnosed as large cell neuroendocrine carcinoma (LCNEC), containing AFP-positive cells only sporadically by immunohistochemistry. He was diagnosed with gastric LCNEC with liver metastasis. Retrospective analysis of endoscopic data obtained at 5 months ago revealed a 0-IIc lesion, approximately 10 mm in size, in the lesser curvature of cardia, the same area of the present gastric tumor. This indicated rapid growth rate of the present tumor. The patient developed jaundice 5 days after he visited our hospital. And he died 18 days after hospital admission.


Alpha fetoprotein Endoscopic ultrasound fine-needle aspiration Gastric cancer Large cell neuroendocrine carcinoma 



The authors would like to thank all the staff involved in treatment of the patient at Mito Saiseikai General Hospital. We would also like to thank Enago for the English language review.

Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.


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Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  1. 1.Departments of GastroenterologyMito Saiseikai General HospitalIbarakiJapan
  2. 2.Department of PathologyMito Saiseikai General HospitalIbarakiJapan

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