Gastric Mixed Adenoneuroendocrine Carcinoma Occurring 50 Years after a Gastroenterostomy with Braun Anastomosis

Gastric Mixed Adenoneuroendocrine Carcinoma Occurring 50 Years after a Gastroenterostomy with Braun Anastomosis

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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 click here (NEC) on the jejunal side.The final pathologic diagnosis was mixed adenoneuroendocrine carcinoma based on an immunohistochemical analysis of endocrine markers and an elevated 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 revlon colorstay lip liner plum secondary bile may have induced a gastric mucosal adenocarcinoma, which finally differentiated into a NEC.