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

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Abstract

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.

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References

  1. Jiang SX, Mikami T, Umezawa A, et al. Gastric large cell neuroendocrine carcinomas: a distinct clinicopathologic entity. Am J Surg Pathol. 2006;30:945–53.

    Article  Google Scholar 

  2. Hirajima S, Komatsu S, Ichikawa D, et al. Liver metastasis is the only independent prognostic factor in AFP-producing gastric cancer. World J Gastroenterol. 2013;19:6055–61.

    Article  Google Scholar 

  3. Murata K, Saito A, Katagiri S, et al. Association of des-γ-carboxy prothrombin production and Sonazoid-enhanced ultrasound findings in hepatocellular carcinomas of different histologic grades. J Med Ultrason. 2001;45(223–229):2018.

    Google Scholar 

  4. Oberstein PE, Kenney B, Krishnamoorthy SK, et al. Metastatic gastric large cell neuroendocrine carcinoma: a case report and review of literature. Clin Colorectal Cancer. 2012;11:218–23.

    Article  Google Scholar 

  5. Ishida M, Sekine S, Fukagawa T, et al. Neuroendocrine carcinoma of the stomach: morphologic and immunohistochemical characteristics and prognosis. Am J Surg Pathol. 2013;37:949–59.

    Article  Google Scholar 

  6. Bourreille J, Metayer P, Sauger F, et al. Existence of alpha feto protein during gastric-origin secondary cancer of the liver. Presse Med. 1970;78:1277–8.

    CAS  PubMed  Google Scholar 

  7. Kono K, Amemiya H, Sekikawa T, et al. Clinicopathologic features of gastric cancers producing alpha-fetoprotein. Dig Surg. 2002;19:359–65.

    Article  CAS  Google Scholar 

  8. Chang YC, Nagasue N, Kohno H, et al. Clinicopathologic features and long-term results of alpha-fetoprotein-producing gastric cancer. Am J Gastroenterol. 1990;85:1480–5.

    CAS  PubMed  Google Scholar 

  9. Chun H, Kwon SJ. Clinicopathological characteristics of alpha-fetoprotein-producing gastric cancer. J Gastric Cancer. 2011;11:23–30.

    Article  Google Scholar 

  10. Liu X, Cheng Y, Sheng W, et al. Clinicopathologic features and prognostic factors in alphafetoprotein-producing gastric cancers: analysis of 104 cases. J Surg Oncol. 2010;102:249–55.

    Article  Google Scholar 

  11. McIntire KR, Waldmann TA, Moertel CG, et al. Serum alpha-fetoprotein in patients with neoplasms of the gastrointestinal tract. Cancer Res. 1975;35:991–6.

    CAS  PubMed  Google Scholar 

  12. Foo KF, Tan CK, Wong KK, et al. A case of alpha-fetoprotein-producing gastric cancer. Ann Acad Med Singapore. 2001;30:58–61.

    CAS  PubMed  Google Scholar 

  13. Chen RJ, Chen CK, Chang DY, et al. Immunoelectrophoretic differentiation of alpha-fetoprotein in disorders with elevated serum alpha-fetoprotein levels or during pregnancy. Acta Oncol. 1995;34:931–5.

    Article  CAS  Google Scholar 

  14. Iso Y, Sawada T, Shimoda M, et al. Solitary AFP- and PIVKA-II-producing hepatoid gastric cancer with giant lymph node metastasis. Hepatogastroenterology. 2005;52:1930–2.

    PubMed  Google Scholar 

  15. Takahashi Y, Endo H, Tange T, et al. Des-gamma carboxy prothrombin (PIVKA-II)- and alpha-fetoprotein (AFP)-producing gastric cancer. J Gastroenterol. 2005;40:432–3.

    Article  Google Scholar 

  16. Ando E, Oriishi T, Toyonaga A, et al. Alpha-fetoprotein- and des-gamma-carboxy prothrombin-producing advanced gastric cancer. Eur J Gastroenterol Hepatol. 2002;14:687–91.

    Article  CAS  Google Scholar 

  17. Song L, Jin Z, Zhang W, Zhang Y. Gastric large cell neuroendocrine carcinoma with venous tumor thrombus: the value of PET/CT and contrast-enhanced computed tomography. Clin Imaging. 2015;39:325–8.

    Article  Google Scholar 

  18. Lipi L, Sachdev R, Gautam D, et al. Triple composite tumor of stomach: a rare combination of alpha fetoprotein positive hepatoid adenocarcinoma, tubular adenocarcinoma and large cell neuroendocrine carcinoma. Indian J Pathol Microbiol. 2014;57:98–100.

    Article  Google Scholar 

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Acknowledgements

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.

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Authors and Affiliations

  1. Departments of Gastroenterology, Mito Saiseikai General Hospital, 3-3-10 Hutabadai, Mito-shi, Ibaraki, 311-4198, Japan

    Koji Takahashi, Takeshi Nihei, Yohei Aoki, Naoaki Konno, Miyuki Nakagawa, Akari Munakata, Ken Okawara & Hiroshi Kashimura

  2. Department of Pathology, Mito Saiseikai General Hospital, Ibaraki, Japan

    Haruo Ohtani

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  1. Koji Takahashi
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  2. Takeshi Nihei
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  3. Yohei Aoki
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  4. Naoaki Konno
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  5. Miyuki Nakagawa
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  9. Hiroshi Kashimura
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Correspondence to Koji Takahashi.

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Takahashi, K., Nihei, T., Aoki, Y. et al. Rapidly progressed large cell neuroendocrine carcinoma of the stomach with an increased serum alpha fetoprotein level: a case report. Clin J Gastroenterol 13, 225–232 (2020). https://doi.org/10.1007/s12328-019-01041-2

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  • DOI: https://doi.org/10.1007/s12328-019-01041-2

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