Gastric Mixed Adenoneuroendocrine Carcinoma with a Trilineage Cell Differentiation: Case Report and Review of the Literature

Abstract

Most gastric neuroendocrine tumours are well differentiated and considered as neuroendocrine neoplasms, whilst poorly differentiated lesions are considered as neuroendocrine carcinomas and account for only 6–16% of gastric neuroendocrine tumours. Gastric mixed adenoneuroendocrine carcinomas are rare malignancies usually composed of a neuroendocrine carcinoma and an adenocarcinoma with a variable grade of differentiation. Here, we report an unusual and rare gastric mixed adenoneuroendocrine carcinoma with a trilineage cell differentiation including a neuroendocrine carcinoma, an adenocarcinoma and a squamous cell carcinoma. A brief discussion of the histopathological features, biological behaviour and treatment of this rare tumour type is presented.

Mixed Adenoneuroendocrine Carcinoma of the Stomach

“…In cases with distant metastases, a combination of cisplatin and etoposide had been recommended. Pericleous et al [ 15 ] reported a case of gastric MANEC with trilineage cell differentiation treated palliatively with long-acting somatostatin analogues. However, the optimal treatment policy is still unclear.…”

Effects of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series.

“…Previous studies have shown that the clinical characteristics of gMANEC largely depend on the proportion of neuroendocrine carcinoma components [36,37]. Fernandes et al believe that the prognosis of gMANEC might be related to whether certain tumor components are more invasive [38]. Furthermore, previous studies have con rmed that sarcopenia is associated with the long-term prognosis of gastric adenocarcinoma patients [10,11].…”

Effects of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series

“…gMANEC is de ned as a malignant tumor with morphological components of glandular epithelial cells and neuroendocrine cells, both of which account for at least more than 30% of the total cells [4]. The clinical characteristics of gMANEC generally depend on the proportion of neuroendocrine carcinoma components [38,39]. Fernandes et al postulated that the prognosis of patients with gMANEC might be related to whether certain tumor components are more invasive [40].…”