Gastric Mixed Adenoneuroendocrine Carcinoma Occurring 50 Years after a Gastroenterostomy with Braun Anastomosis

A 75-year-old man was diagnosed with gastric cancer. Fifty years previously, he had undergone gastroenterostomy with a Braun enteroenterostomy. At present, a distal gastrectomy and small intestinal partial resection were performed. Intraoperatively, the tumor was localized to the previous stomal sit...

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Bibliographic Details
Published in:Case reports in oncology 2014-05, Vol.7 (2), p.330-336
Main Authors: Nemoto, Hiroshi, Tate, Genshu, Yokomizo, Kazuaki, Umemoto, Takahiro, Matsubara, Taketo, Mizukami, Hiroki, Kigawa, Gaku, Matsumiya, Akihiko, Tanaka, Junichi
Format: Article
Language:English
Subjects:
Braun enteroenterostomy
Gastroenterostomy
Mixed adenoneuroendocrine carcinoma
Neuroendocrine carcinoma
Published: May 2014
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Summary:A 75-year-old man was diagnosed with gastric cancer. Fifty years previously, he had undergone gastroenterostomy with a Braun enteroenterostomy. At present, a distal gastrectomy and small intestinal partial resection were performed. Intraoperatively, the tumor was localized to the previous stomal site. HE staining showed that the tumor comprised two elements: a tubular adenocarcinoma on the gastric side and a neuroendocrine carcinoma (NEC) on the jejunal side. The final pathologic diagnosis was mixed adenoneuroendocrine carcinoma based on an immunohistochemical analysis of endocrine markers and an elevated Ki-67 labeling index. The risk of later cancer development cancer recurrence near the gastrojejunostomy site is well known. Potentially, chronic enterogastric bile reflux may irritate the gastric mucosa and act as a promoter. Gastric NEC has a strong malignant potential. We suspect that, in the present case, the constant exposure to secondary bile may have induced a gastric mucosal adenocarcinoma, which finally differentiated into a NEC.
ISSN:1662-6575
1662-6575
DOI:10.1159/000363222