같은 종양에서 깊이에 따라 분포된 혼합형 신경내분비-비신경내분비암의 증례: 2010년 세계보건기구에서 정의한 혼합형 샘-신경내분비암 정의에 부합하지 않는 암
Mixed Neuroendocrine-non-neuroendocrine Neoplasm of the Stomach that is Distributed in Depth on the Same Tumor: Inconsistent with the Definition of Mixed Adenoneuroendocrine Carcinoma in the 2010 World Health Organization Classification of Tumors of the Digestive System
정준호, 정경원, 김재현, 김성은, 문원, 박무인, 박선자,
소속 상세정보
정준호 ( Jeong Joon-Ho )
고신대학교 의과대학 내과학교실
정경원 ( Jung Kyoung-Won )
고신대학교 의과대학 내과학교실
김재현 ( Kim Jae-Hyun )
고신대학교 의과대학 내과학교실
김성은 ( Kim Sung-Eun )
고신대학교 의과대학 내과학교실
문원 ( Moon Won )
고신대학교 의과대학 내과학교실
박무인 ( Park Moo-In )
고신대학교 의과대학 내과학교실
박선자 ( Park Seon-Ja )
고신대학교 의과대학 내과학교실
Abstract
A mixed adenoneuroendocrine carcinoma (MANEC) of the stomach is a rare disease entity that was first defined by the World Health Organization (WHO) classification (2010) for tumors of the digestive system. According to the WHO classification (2010), MANEC is referred to as a tumor with both neuroendocrine and non-neuroendocrine neoplasms; each component of the tumor should be at least 30%. On the other hand, this cut-off value lacks clinical evidence and does not explain the characteristics and heterogeneity of this tumor. A 66-year-old male diagnosed with early gastric cancer (EGC) at a community hospital was referred to the Kosin University Gospel Hospital for further evaluation of gastric cancer. Esophagogastroduodenoscopy and EUS performed at the Kosin University Gospel Hospital revealed a sub-mucosal tumor-like component. In addition, a re-biopsy revealed a neuroendorine tumor at different depths of the same tumor. The final pathologic-diagnosis through surgery revealed a mixed neuroendocrine- non-neuroendocrine neoplasm, which is inconsistent with the definition of MANEC. Clinicians should consider EUS when a tumor has atypical endoscopic findings, even if EGC has already been diagnosed.
키워드
Stomach neoplasms; Adenocarcinoma; Neuroendocrine tumors; World Health Organization
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