Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 28, 2006; 12(44): 7216-7220
Published online Nov 28, 2006. doi: 10.3748/wjg.v12.i44.7216
Synchronous occurrence of carcinoid, signet-ring cell carcinoma and heterotopic pancreatic tissue in stomach: A case report and literature review
Lin Yang, Hong-Tu Zhang, Xun Zhang, Yun-Tian Sun, Zhi Cao, Qin Su
Lin Yang, Hong-Tu Zhang, Xun Zhang, Yun-Tian Sun, Zhi Cao, Qin Su, Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Correspondence to: Qin Su, Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. q.su@wjgnet.com
Telephone: +86-10-87788435 Fax: +86-10-67713359
Received: March 7, 2006
Revised: March 28, 2006
Accepted: October 9, 2006
Published online: November 28, 2006
Abstract

We presented an unusual case with coexistence of carcinoid, signet-ring cell carcinoma (SRC) and heterotopic pancreatic tissue in stomach. Gastroscopic examination of this 63-year-old male patient showed multiple protrusions in gastric corpus near the greater curvature, identified by subsequent biopsy as carcinoid. Distal subtotal gastrectomy was performed. Histological and immunohistochemical examinations showed a carcinoid tumor in gastric corpus near the greater curvature, an intramucosal SRC at the lesser curvature of corpus and heterotopic pancreatic tissue in muscularis propria of the antrum at the lesser curvature with hyperplasia of peripheral endocrine cells producing multiple pancreatic hormones. We reviewed the literatures on clinicopathological characteristics and the differential diagnosis of the above three abnormalities, and concluded that the carcinoid in corpus near the greater curvature and SRC in the lesser curvature are independent lesions; the foci of endocrine cells in the muscularis propria and serosa are hyperplastic lesions from the heterotopic pancreatic tissue, rather than dissemination of carcinoid in corpus.

Keywords: Heterotopic pancreas; Carcinoid; Signet- ring cell carcinoma; Gastric tumour; Endocrine cell hyperplasia