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Successful combination chemotherapy with irinotecan hydrochloride and cisplatin for primary gastric small cell carcinoma: report of a case.

Funahashi H, Miyai H, Wakasugi T, Ishiguro H, Matsuo Y, Kimura M, Takeyama H - World J Surg Oncol (2013)

Bottom Line: The patient was a 71-year-old male who was admitted to a local hospital with anemia.Gastrointestinal endoscopy revealed the presence of advanced gastric carcinoma at the upper region of the stomach.The patient underwent surgery, and the pathological diagnosis was small cell carcinoma due to the presence of the typical features of small round cells with scant cytoplasm that were positive for synaptophysin and chromogranin A in the resected specimen.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 4678601, Japan. funa84@med.nagoya-cu.ac.jp.

ABSTRACT
Primary gastric small cell carcinoma is a rare and aggressive malignant disease with a poor prognosis that was first reported in 1976 by Matsusaka et al. The incidence is very low and the clinicopathological features are similar to those of small cell lung carcinoma.We herein report a case of successful treatment by combination chemotherapy consisting of irinotecan hydrochloride and cisplatin for primary gastric small cell carcinoma. The patient was a 71-year-old male who was admitted to a local hospital with anemia. Gastrointestinal endoscopy revealed the presence of advanced gastric carcinoma at the upper region of the stomach. The patient underwent surgery, and the pathological diagnosis was small cell carcinoma due to the presence of the typical features of small round cells with scant cytoplasm that were positive for synaptophysin and chromogranin A in the resected specimen. The patient underwent subsequent combination chemotherapy, which provided him with over 1 year of survival and a good quality of life. We also present a review of the literature regarding chemotherapy for primary gastric small cell carcinoma.

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Related in: MedlinePlus

Tumor location and formTumor location and form. Abdominal computed tomography (CT) scans showed carcinoma at the esophagogastric junction (white arrow) and lymph node swelling (dotted arrow) before surgery (A). Macroscopic findings of the resected stomach: a Borrmann type III tumor that measured approximately 100 mm in diameter was located around the esophagogastric junction (B).
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Figure 1: Tumor location and formTumor location and form. Abdominal computed tomography (CT) scans showed carcinoma at the esophagogastric junction (white arrow) and lymph node swelling (dotted arrow) before surgery (A). Macroscopic findings of the resected stomach: a Borrmann type III tumor that measured approximately 100 mm in diameter was located around the esophagogastric junction (B).

Mentions: A 71-year-old Japanese male went to a local hospital for postoperative follow-up of colonic carcinoma. Then anemia was noted, and gastrointestinal endoscopy revealed a large ulcerated tumor around the esophagogastric junction. Tumor biopsy specimens showed adenocarcinoma, and he was admitted to Nagoya City University Hospital for curative treatment. His family history was unremarkable, and medical history included acute myocardial infarction, bladder carcinoma, and colon carcinoma. Laboratory data were within normal limits except for anemia indicated by a hemoglobin (Hb) level of 9.4 g/dL (normal range: 13.2 g/dL < Hb < 17.2 g/dL). Serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19–9 (CA19-9) were also within normal limits: 1.6 ng/mL (normal range <3.5 ng/mL) and 3.7 U/mL (normal range <37 U/mL), respectively. On computed tomography (CT), the tumor appeared as a thickening of the gastric wall with metastasis to perigastric lymph nodes (LN) (Figure 1A). Re-examination with gastrointestinal endoscopy revealed a Borrmann type III tumor located around the esophagogastric junction, which was diagnosed as GSCC upon histological examination of a biopsy specimen at our hospital. After providing informed consent, and following a sufficiently detailed explanation about his disease, the patient wished to undergo surgery. Surgical resection by proximal gastrectomy was performed. While total gastrectomy is the standard treatment for such cases, proximal gastrectomy was selected during surgery, because his small bowel, which was one lump due to previous surgery, could not be elevated to allow Rou-en-Y reconstruction.


Successful combination chemotherapy with irinotecan hydrochloride and cisplatin for primary gastric small cell carcinoma: report of a case.

Funahashi H, Miyai H, Wakasugi T, Ishiguro H, Matsuo Y, Kimura M, Takeyama H - World J Surg Oncol (2013)

Tumor location and formTumor location and form. Abdominal computed tomography (CT) scans showed carcinoma at the esophagogastric junction (white arrow) and lymph node swelling (dotted arrow) before surgery (A). Macroscopic findings of the resected stomach: a Borrmann type III tumor that measured approximately 100 mm in diameter was located around the esophagogastric junction (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3852596&req=5

Figure 1: Tumor location and formTumor location and form. Abdominal computed tomography (CT) scans showed carcinoma at the esophagogastric junction (white arrow) and lymph node swelling (dotted arrow) before surgery (A). Macroscopic findings of the resected stomach: a Borrmann type III tumor that measured approximately 100 mm in diameter was located around the esophagogastric junction (B).
Mentions: A 71-year-old Japanese male went to a local hospital for postoperative follow-up of colonic carcinoma. Then anemia was noted, and gastrointestinal endoscopy revealed a large ulcerated tumor around the esophagogastric junction. Tumor biopsy specimens showed adenocarcinoma, and he was admitted to Nagoya City University Hospital for curative treatment. His family history was unremarkable, and medical history included acute myocardial infarction, bladder carcinoma, and colon carcinoma. Laboratory data were within normal limits except for anemia indicated by a hemoglobin (Hb) level of 9.4 g/dL (normal range: 13.2 g/dL < Hb < 17.2 g/dL). Serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19–9 (CA19-9) were also within normal limits: 1.6 ng/mL (normal range <3.5 ng/mL) and 3.7 U/mL (normal range <37 U/mL), respectively. On computed tomography (CT), the tumor appeared as a thickening of the gastric wall with metastasis to perigastric lymph nodes (LN) (Figure 1A). Re-examination with gastrointestinal endoscopy revealed a Borrmann type III tumor located around the esophagogastric junction, which was diagnosed as GSCC upon histological examination of a biopsy specimen at our hospital. After providing informed consent, and following a sufficiently detailed explanation about his disease, the patient wished to undergo surgery. Surgical resection by proximal gastrectomy was performed. While total gastrectomy is the standard treatment for such cases, proximal gastrectomy was selected during surgery, because his small bowel, which was one lump due to previous surgery, could not be elevated to allow Rou-en-Y reconstruction.

Bottom Line: The patient was a 71-year-old male who was admitted to a local hospital with anemia.Gastrointestinal endoscopy revealed the presence of advanced gastric carcinoma at the upper region of the stomach.The patient underwent surgery, and the pathological diagnosis was small cell carcinoma due to the presence of the typical features of small round cells with scant cytoplasm that were positive for synaptophysin and chromogranin A in the resected specimen.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 4678601, Japan. funa84@med.nagoya-cu.ac.jp.

ABSTRACT
Primary gastric small cell carcinoma is a rare and aggressive malignant disease with a poor prognosis that was first reported in 1976 by Matsusaka et al. The incidence is very low and the clinicopathological features are similar to those of small cell lung carcinoma.We herein report a case of successful treatment by combination chemotherapy consisting of irinotecan hydrochloride and cisplatin for primary gastric small cell carcinoma. The patient was a 71-year-old male who was admitted to a local hospital with anemia. Gastrointestinal endoscopy revealed the presence of advanced gastric carcinoma at the upper region of the stomach. The patient underwent surgery, and the pathological diagnosis was small cell carcinoma due to the presence of the typical features of small round cells with scant cytoplasm that were positive for synaptophysin and chromogranin A in the resected specimen. The patient underwent subsequent combination chemotherapy, which provided him with over 1 year of survival and a good quality of life. We also present a review of the literature regarding chemotherapy for primary gastric small cell carcinoma.

Show MeSH
Related in: MedlinePlus