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 Jandy FloPro Parts based on an immunohistochemical analysis of endocrine markers and an elevated Sanitizer Test Strips/Labels 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.