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Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult

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Summary:Abstract Introduction: Gastric cancer is the fourth most common cause of cancer death, with more than 90% of the cases being adenocarcinomas. Among the diverse subtypes, mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is one of the rarest types. Gastric cancer can manifest with significant bleeding in up to 5% of patients. Case Presentation: The authors present a case of a healthy 26-year-old male who experienced two episodes of major upper gastrointestinal bleeding that were resolved with endoscopic treatment. During the second endoscopy, a 15-mm nodular subepithelial lesion was identified at the gastroesophageal junction. Endoscopic ultrasound revealed a homogeneous and hypoechoic lesion with well-defined limits in the deep mucosa. Histological examination of the biopsies showed an adenocarcinoma. The patient later underwent a distal esophagectomy and a total gastrectomy, followed by chemotherapy. Histological examination of the surgical specimen showed a mixed adenoneuroendocrine carcinoma composed of an ade nocarcinoma with tubular/glandular pattern and signet ring cells and a large cell-type neuroendocrine carcinoma. The neoplasia had infiltrated the outer muscular layers of the stomach and had disseminated to 3 regional lymph nodes, leading to its classification as stage IIb. Two years following the treatment, there is no evidence of recurrence. All genetic tests applied were negative. Discussion: A MiNEN occurs when both neuroendocrine and non-neuroendocrine components represent at least 30% of the lesion. Due to its rarity, epidemiology and standard treatment are not well established because most data published are from case reports. In this context, we present a compelling case study, highlighting the patient’s young age, the rarity of this specific cancer, and its uncommon presentation.
Main Authors:Carvalho,Tânia
Other Authors:Coutada,Andreia; Jácome,Manuel; Fernandes,Dália
Subject:Gastric cancer Mixed neuroendocrine-non-neuroendocrine neoplasm Upper gastrointestinal bleeding
Year:2024
Country:Portugal
Document type:report
Access type:open access
Associated institution:Fundação para a Ciência e Tecnologia
Language:English
Origin:SciELO Portugal
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author Carvalho,Tânia
author2 Coutada,Andreia
Jácome,Manuel
Fernandes,Dália
author2_role author
author
author
author_facet Carvalho,Tânia
Coutada,Andreia
Jácome,Manuel
Fernandes,Dália
author_role author
country_str PT
creators_json_txt [{\"Person.name\":\"Carvalho,Tânia\"},{\"Person.name\":\"Coutada,Andreia\"},{\"Person.name\":\"Jácome,Manuel\"},{\"Person.name\":\"Fernandes,Dália\"}]
datacite.creators.creator.creatorName.fl_str_mv Carvalho,Tânia
Coutada,Andreia
Jácome,Manuel
Fernandes,Dália
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Gastric cancer
Mixed neuroendocrine-non-neuroendocrine neoplasm
Upper gastrointestinal bleeding
datacite.titles.title.fl_str_mv Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult
dc.creator.none.fl_str_mv Carvalho,Tânia
Coutada,Andreia
Jácome,Manuel
Fernandes,Dália
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452024000600056
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Gastrenterologia
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv GE-Portuguese Journal of Gastroenterology v.31 n.6 2024
dc.subject.none.fl_str_mv Gastric cancer
Mixed neuroendocrine-non-neuroendocrine neoplasm
Upper gastrointestinal bleeding
dc.title.fl_str_mv Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_93fc
description Abstract Introduction: Gastric cancer is the fourth most common cause of cancer death, with more than 90% of the cases being adenocarcinomas. Among the diverse subtypes, mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is one of the rarest types. Gastric cancer can manifest with significant bleeding in up to 5% of patients. Case Presentation: The authors present a case of a healthy 26-year-old male who experienced two episodes of major upper gastrointestinal bleeding that were resolved with endoscopic treatment. During the second endoscopy, a 15-mm nodular subepithelial lesion was identified at the gastroesophageal junction. Endoscopic ultrasound revealed a homogeneous and hypoechoic lesion with well-defined limits in the deep mucosa. Histological examination of the biopsies showed an adenocarcinoma. The patient later underwent a distal esophagectomy and a total gastrectomy, followed by chemotherapy. Histological examination of the surgical specimen showed a mixed adenoneuroendocrine carcinoma composed of an ade nocarcinoma with tubular/glandular pattern and signet ring cells and a large cell-type neuroendocrine carcinoma. The neoplasia had infiltrated the outer muscular layers of the stomach and had disseminated to 3 regional lymph nodes, leading to its classification as stage IIb. Two years following the treatment, there is no evidence of recurrence. All genetic tests applied were negative. Discussion: A MiNEN occurs when both neuroendocrine and non-neuroendocrine components represent at least 30% of the lesion. Due to its rarity, epidemiology and standard treatment are not well established because most data published are from case reports. In this context, we present a compelling case study, highlighting the patient’s young age, the rarity of this specific cancer, and its uncommon presentation.
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person_str_mv Carvalho,Tânia
Coutada,Andreia
Jácome,Manuel
Fernandes,Dália
publishDate 2024
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spelling Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young AdultCarvalho,TâniaCoutada,AndreiaJácome,ManuelFernandes,DáliaGastric cancerMixed neuroendocrine-non-neuroendocrine neoplasmUpper gastrointestinal bleedingopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452024000600056URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452024000600056URLHasVersion2024-12-01Abstract Introduction: Gastric cancer is the fourth most common cause of cancer death, with more than 90% of the cases being adenocarcinomas. Among the diverse subtypes, mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is one of the rarest types. Gastric cancer can manifest with significant bleeding in up to 5% of patients. Case Presentation: The authors present a case of a healthy 26-year-old male who experienced two episodes of major upper gastrointestinal bleeding that were resolved with endoscopic treatment. During the second endoscopy, a 15-mm nodular subepithelial lesion was identified at the gastroesophageal junction. Endoscopic ultrasound revealed a homogeneous and hypoechoic lesion with well-defined limits in the deep mucosa. Histological examination of the biopsies showed an adenocarcinoma. The patient later underwent a distal esophagectomy and a total gastrectomy, followed by chemotherapy. Histological examination of the surgical specimen showed a mixed adenoneuroendocrine carcinoma composed of an ade nocarcinoma with tubular/glandular pattern and signet ring cells and a large cell-type neuroendocrine carcinoma. The neoplasia had infiltrated the outer muscular layers of the stomach and had disseminated to 3 regional lymph nodes, leading to its classification as stage IIb. Two years following the treatment, there is no evidence of recurrence. All genetic tests applied were negative. Discussion: A MiNEN occurs when both neuroendocrine and non-neuroendocrine components represent at least 30% of the lesion. Due to its rarity, epidemiology and standard treatment are not well established because most data published are from case reports. In this context, we present a compelling case study, highlighting the patient’s young age, the rarity of this specific cancer, and its uncommon presentation.Sociedade Portuguesa de GastrenterologiaGE-Portuguese Journal of Gastroenterology v.31 n.6 2024text/htmlengreporthttp://purl.org/coar/resource_type/c_93fcother research product
spellingShingle Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult
Carvalho,Tânia
Gastric cancer
Mixed neuroendocrine-non-neuroendocrine neoplasm
Upper gastrointestinal bleeding
status SINGLETON
subject.fl_str_mv Gastric cancer
Mixed neuroendocrine-non-neuroendocrine neoplasm
Upper gastrointestinal bleeding
title Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult
title_full Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult
title_fullStr Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult
title_full_unstemmed Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult
title_short Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult
title_sort Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult
topic Gastric cancer
Mixed neuroendocrine-non-neuroendocrine neoplasm
Upper gastrointestinal bleeding
topic_facet Gastric cancer
Mixed neuroendocrine-non-neuroendocrine neoplasm
Upper gastrointestinal bleeding
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452024000600056
visible 1