CAZURI CLINICE - CASE STUDIES
MALIGNANT GASTRIC CARCINOID TUMOR– CASE REPORT
G. Dimofte, E. Molodoi, Gabriela Lozneanu,
D. Negru*, FeliciaCrumpei*, Niculina Florea**, D. Ferariu**
First Surgical Clinic, Research Center for Laparoscopic and Classic
Surgery,
*Clinic of Radiology,
**Department of Morfopathology,
„St. Spiridon” University Hospital, University of Medicine
and Pharmacy Iasi
Jurnalul de chirurgie 2005; 1 (1):81-86
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Abstract
We describe an unusual presentation of a highly malignant type III
gastric carcinoid tumor, an incidental finding in a 60 years old female
admitted for gallstone disease. The case is presented in a historical
fashion, with every stage diagnosis described and reasoned. A well
confined liver tumor was falsely assumed as a liver haemangioma, while
the primary gastric tumor was revealed only after the passage of a
naso-gastric tube which triggered an upper gastro-intestinal bleeding
episode.
Diagnostic endoscopy revealed a small tumor, but histological examination
on biopsy specimen suggested a poorly differentiated carcinoma. Standard
total gastrectomy with D2 lymphadenectomy was performed, with good
tumor clearance but local metastases were confirmed in adjacent lymphnodes.
Final pathology proved a type III highly malignant carcinoid tumor,
with mixed cellularity.
Follow-up 3 months later showed an explosive development of the liver
tumors demonstrating not only the metastatic origin but also the aggressiveness
the sporadic gastric carcinoid tumor. Although prognosis is very poor
we believe that the errors that marked such a difficult diagnosis
could bring back in attention the rare condition of a sporadic gastric
carcinoid which can represent up to 30% of all carcinoid tumors, but
only 1% of all gastric tumors. Unusual aspects of liver metastases
should prompt biopsy and histological confirmation.
KEYWORDS: GASTRIC CARCINOID TUMOR, LIVER METASTASIS
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