Synchronous gastric neuroendocrine carcinoma and hepatocellular carcinoma: a case report

Abstract

Gastric neuroendocrine carcinomas (NECs) are rare tumours that are divided into four subtypes depending on tumour characteristics. Patients with NECs are known to have an increased risk of synchronous and metachronous cancers mainly located in the gastrointestinal tract. A case of synchronous gastric NEC and hepatocellular carcinoma in a patient with several other precancerous lesions is presented. The patient had anaemia, and a gastric tumour and two duodenal polyps were identified on upper endoscopy. A CT scan of the abdomen revealed several lesions in the liver. The lesions were invisible on B-mode sonography and real-time sonography fused with CT was used to identify and biopsy one of the lesions. Histology showed hepatocellular carcinoma. A literature search showed that only one case of a hepatocellular carcinoma synchronous with a gastric NEC has been reported previously.

Trial registration number: NCT00781924.

Figures

Figure 1

Upper endoscopy. A. Photograph of the gastric type IV neuroendocrine tumour. B. Endoscopic sonography shows the hypoechoic tumour.

Figure 2

CT and sonography. A. CT image showing suspect liver lesions marked with white horizontal arrows. B. Real-time sonography fused with CT; sonogram to the left and reformatted CT image to the right. The liver lesion marked with a white horizontal arrow corresponds to the central lesion in the CT image. C. Contrast enhanced sonography; B-mode image to the left and contrast enhanced image to the right. The central liver lesion is marked with a white horizontal arrow.