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KMID : 0880520080440030188
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Chonnam Medical Journal
2008 Volume.44 No. 3 p.188 ~ p.193
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A Case of Gastric Adenocarcinoma Developed in Neuroendocrine Carcinoma after Chemotherapy
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Lim Seong-Uk
Chung Ik-Joo
Cho Sang-Hee
Seo Seong-Rye
Yoon Ju-Young
Cho Dae-Ho
Bae Soo-Young
Bae Woo-Kyun
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Abstract
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A 69-year-old male visited our medical center with hematemesis. Gastrofibroscopy revealed a 4.5 cm sized fungating mass on anterior wall of gastric lower body. Biopsy specimens showed a carcinoma of neuroendocrine components with strong positive for synaptophysin stain. Because he had a metastatic neuroendocrine carcinoma with multiple metastasis of liver, we treated him with chemotherapy of etoposide and cisplatin. The primary lesion showed nearly complete response after 6th cycles of chemotherapy, however it was regrowed with chemoresistance and mutifocal lesion in stomach and liver. Endoscopic biopsy on same previous lesion revealed a poorly differentiated tubular adenocarcinoma with negative for synaptophysin. After conversion to another tumor type, the treatment outcome was progressed in spite of salvage chemotherapy for gastric adenocarcinoma. He died 17 months after diagnosis. The immunohistological change of same mass after chemotherapy suggests a possibility of other course of differentiation from common pleuripotent cells of adenocarcinoma and neuroendocrine carcinoma after chemotherapy.
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KEYWORD
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Stomach, Carcinoma, Neuroendocrine, Adenocarcinoma
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