Gastric Small-Cell Carcinoma Found on Esophagogastroduodenoscopy: A Case Report and Literature Review

Abstract

Introduction. Characterized as an undifferentiated, neuroendocrine tumor arising from totipotent stem cells, small-cell carcinoma (SCC) most commonly arises from the lung. Extrapulmonary small-cell carcinomas (ESCC) are rare and account for only four percent of SCC. Gastric ESCC, more commonly seen in Japanese male patients in their seventh decade of life, accounts for approximately 0.1 percent of ESCC. Case Presentation. A 75-year-old Hispanic male presented with a several week history of worsening epigastric pain with nausea and vomiting. Computer tomography (CT) of the abdomen and pelvis showed a large heterogeneous mass involving the posterior gastric wall with diffuse extension into the gastric cardia. Esophagogastroduodenoscopy (EGD) revealed a large fungating mass in the lesser curvature of the stomach. Biopsy of the mass revealed small-cell carcinoma of the stomach. The patient was diagnosed with extensive/stage 4 disease and started on chemoradiation. Discussion. Our case, of a very rare condition highlights, the importance of recognizing atypical pathologic diagnoses. More research will need to be conducted with GSCC patients in order to better characterize disease pathogenesis, genetic mutations, and optimal disease management. The hope is to identify biomarkers that will identify patients earlier in their disease course when cure is possible.

Management of treatment-naïve limited-stage small cell esophagus carcinoma

“… 1 , 2 It has been increasingly recognized that SCEC is a clinicopathological entity with an absolutely different biological behavior and prognosis distinct from squamous and adenocarcinomas of the esophagus, but similar to small cell carcinoma that arises in the lung and other extrapulmonary organs. 3 - 5 The clinical course of these tumors is highly aggressive in general, with early dissemination, frequent recurrences, and poor prognosis. Even with improved diagnostic capabilities, the diagnosis is still difficult in some cases, especially poorly differentiated squamous or adenomatous carcinoma, because of the small biopsy sample.…”

Primary Gastric Small Cell Carcinoma (Presenting as Linitis Plastica) Diagnosed Using Endoscopic Ultrasound-Guided Biopsy: A Case Report

“…GSCC is associated with a high incidence of lymphovascular invasion, marked deep infiltration, and distant metastases [5]. Given its rarity and lack of randomized controlled trials, the standard treatment for primary GSCC has not yet been established [6].…”

Small cell carcinoma of the stomach: A report of two cases and a review of the literature

“…The pathological characteristics and the immunohistochemical features of SCGC are essentially identical to those of SCLC ( 4 , 6 , 11 , 15 – 21 ). However, almost half of SCGC cases are ‘mixed’ or ‘combined’ tumors, comprised of SCC and nonSCC components ( 6 , 11 , 22 , 23 ).…”