Mixed adenoneuroendocrine carcinoma of the gastric stump following Billroth II gastrectomy: case report and review of the literature

Cazzo, Everton; Saito, Helena de Almeida de Paes

doi:10.1590/1516-3180.2013.9080911

Cited by 6 publications

(12 citation statements)

References 18 publications

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“…The quantitative composition of the primary tumour was described in 36 studies (n = 294) [12,15,17,19,21,[23][24][25]27,29,30,34,36,[39][40][41]45,46,[48][49][50][52][53][54]56,57,59,65,73,74,80,82,[84][85][86]92]; the two components were present in equal proportion in 27.9% (n = 82) of cases, whereas in the remaining 72.1% one of the two histologies was predominant; the neuroendocrine component in 42.2% (n = 124), the non-neuroendocrine component in 29.9% (n = 88).…”

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

“…Among 69 studies (n = 667) reporting the grade of differentiation of the neuroendocrine component [11][12][13][14][15][16][17][18][19][21][22][23][24][25][26][27][28][29][54][55][56][57][58][59][60][61][62]68,71,[73][74][75]79,80,82,[84][85][86][87]89,[91][92][93]96,97,100,101], a large proportion of MiNENs (92.5%; n = 617) had a grade 3 neuroendocrine component, whereas 4.3% (n = 29) and 3.1% (n = 21) had a grade 1 and a grade 2 neuroendocrine component, respectively. Among MiNENs with a grade 3 neuroendocrine component, the morphological subtype (large cell or small cell) was reported in 25 studies (n = 241) [11,…”

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

“…Interestingly, in 43 studies (n = 61) where more than one diagnostic sample was available [11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]30,[32][33][34][36][37][38][39][41][42][43][44][45][46][47]49,50,53,55,[59][60][61][62]64,65,96], the initial diagnosis from the first sample collected (either cytological or histological) was in keeping with MiNEN or suspicion of MiNEN in 36.1% (n = 22) of cases, adenocarcinoma in 36.1% (n = 22), poorly differentiated neuroendocrine carcinoma in 21.3% (n = 13), and well differentiated neuroendocrine tumour in 6.6% (n = 4).…”

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

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Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

Frizziero

Chakrabarty

Nagy

et al. 2020

JCM

122

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Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) represent a rare diagnosis of the gastro-entero-pancreatic tract. Evidence from the current literature regarding their epidemiology, biology, and management is of variable quality and conflicting. Based on available data, the MiNEN has an aggressive biological behaviour, mostly driven by its (often high-grade) neuroendocrine component, and a dismal prognosis. In most cases, the non-neuroendocrine component is of adenocarcinoma histology. Due to limitations in diagnostic methods and poor awareness within the scientific community, the incidence of MiNENs may be underestimated. In the absence of data from clinical trials, MiNENs are commonly treated according to the standard of care for pure neuroendocrine carcinomas or adenocarcinomas from the same sites of origin, based on the assumption of a biological similarity to their pure counterparts. However, little is known about the molecular aberrations of MiNENs, and their pathogenesis remains controversial; molecular/genetic studies conducted so far point towards a common monoclonal origin of the two components. In addition, mutations in tumour-associated genes, including TP53, BRAF, and KRAS, and microsatellite instability have emerged as potential drivers of MiNENs. This systematic review (91 full manuscripts or abstracts in English language) summarises the current reported literature on clinical, pathological, survival, and molecular/genetic data on MiNENs.

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Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

See 1 more Smart Citation

Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

Frizziero

Chakrabarty

Nagy

et al. 2020

JCM

122

View full text Add to dashboard Cite

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“…Jiang reported that mixed tumors have a longer overall survival and median progression free survival than that of pure large cell NEC, which is considered as the most aggressive subgroup. However, a previous study about colorectal MANEC reported that there was no statistical significant differences in survival rate between colorectal MANECs and pure neuroendocrine tumors, [ 29 ] suggested that tumor site may be a prognostic factors. The intermediate grade malignant MANEC, in which the adenocarcinoma component is biologically more aggressive than the neuroendocrine one, show an equivalent outcome than the adenocarcinoma.…”

Section: Discussionmentioning

confidence: 98%

Correlation of metastasis characteristics with prognosis in gastric mixed adenoneuroendocrine carcinoma

Tang

Zhou²,

Chen³

et al. 2017

Medicine

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Rationale:This article is aimed to retrospect the clinicopathological data of 2 cases of gastric MANENCs. MANEC is a rare biphasic tumor type that is coexistence of dual neuroendocrine and adenocarcinoma differentiation with each composing exceeding 30% volume. Gastric MANEC have just been reported anecdotally in the literature due to their rarity and heterogeneity. According to our study, these neoplasms have 3 different metastasis patterns: only adenocarcinomatous or neuroendocrine carcinoma and both of the 2 components. We first focus on the correlation of metastasis characteristics with prognosis in gastric MANEC, which may be potential implications for the choice of chemotherapy.Patient concerns:The 2 cases of patient shared several symptoms: epigastric discomfort, weight loss, hematemesis, or melena.Diagnosis:The 2 patients were diagnosis as MANEC based on the identification of histopathological analysis. In case 1, the poor differentiated adenocarcinoma accounted for 30%, the neuroendocrine part account for 70% and both of the 2 components metastasized to the lymph nodes, whereas in case 2, poorly differentiated adenocarcinoma accounted for 70%, the neuroendocrine part for 30% and only the glandular component invaded regional lymph nodes.Interventions:The first patient underwent laparoscopic radical gastrectomy and underwent adjuvant chemotherapy, combination of cisplatin, and etoposide successfully. The second patient received radical gastronomy, and did not receive any chemotherapy due to general weakness.Outcomes:The first patient is alive with no evidence of recurrence, and the second patient died 6 months after the operation.Lessons:The assessment of metastatic sites should be a routine pathological practice, which is crucial for clinical decision-making and the selection of management.

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“…Gastric stump cancer (GSC) is a well-known long-term complication after distal gastrectomy, and has been reported to account for 1%-8% of all gastric cancers. The most common form of GSC is adenocarcinoma[ 1 ], although various types of gastric stump malignancies have been reported[ 2 - 6 ]. Development of neuroendocrine carcinoma (NEC) from the gastric stump is extremely rare.…”

Section: Introductionmentioning

confidence: 99%

Neuroendocrine carcinoma of the gastric stump: A case report and literature review

Xue

Chen

et al. 2018

WJG

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We herein report a case of neuroendocrine carcinoma of the gastric stump found 47 years after Billroth II gastric resection for a benign gastric ulcer. A 74-year-old man was referred to another hospital with melena. Endoscopic examination revealed a localized ulcerative lesion at the gastrojejunal anastomosis. The diagnosis by endoscopic biopsy was neuroendocrine carcinoma. A total gastrectomy of the remnant stomach with D2 lymphadenectomy was performed at our hospital. The lesion invaded the subserosa, and metastasis was found in two of nine the lymph nodes retrieved. The lesion was positive for synaptophysin and chromogranin A, and the Ki-67 labeling index was 60%. The diagnosis of neuroendocrine carcinoma of the gastric stump was confirmed using World Health Organization 2010 criteria. Subsequently, the patient underwent one course of adjuvant chemotherapy with the etoposide plus cisplatin (EP) regimen; however, treatment was discontinued due to grade 3 myelosuppression. The patient showed lymph node metastasis in the region around the gastrojejunal anastomosis in the abdominal cavity 7 mo post-surgery. He then underwent radiotherapy and platinum-based combination chemotherapy; however, the disease progressed and liver recurrence was observed on follow-up computed tomography at 16 mo post-surgery. The patient then received chemotherapy with regimens used for the treatment of small cell lung cancer in first- and second-line settings. The patient died of disease progression 31 months after surgery.

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Mixed adenoneuroendocrine carcinoma of the gastric stump following Billroth II gastrectomy: case report and review of the literature

Cited by 6 publications

References 18 publications

Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

Correlation of metastasis characteristics with prognosis in gastric mixed adenoneuroendocrine carcinoma

Neuroendocrine carcinoma of the gastric stump: A case report and literature review

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