Advanced Gastric Neuroendocrine Carcinoma: A Diagnostic and Management Conundrum Abstract #2193

Introduction: Gastric neuroendocrine carcinomas are rare tumors with a high malignant trait and poor prognosis. Endogenous hypercortisolism associated with neuroendocrine carcinomas can have a negative impact on patients' survival.
Aim(s): To report a case of advanced gastric neuroendocrine carcinoma associated with hypercortisolism.
Materials and methods: A 57 year old Caucasian male was referred to our department with the diagnosis of advanced gastric neuroendocrine carcinoma (endoscopic biopsies). The immunohistochemical staining was positive for chromogranin, synaptophysin, SSTR2 and SSTR5, with a Ki67 of 70%. The initial staging of the disease by computed tomography revealed the gastric tumor (58/54mm) with hepatic and lymph node metastases. Due to high glucose levels (requiring insulin therapy) coupled with high blood pressure and hypokalaemia, the endocrinological evaluation demonstrated the presence of hypercortisolism, concomitant with an elevated ACTH-132.3pg/ml. Additionally, the brain MRI showed the presence of a pituitary microadenoma (4.1/2.9mm).
Conference: 15th Annual ENETS conference 2018 (2018)
Category: Case reports
Presenting Author: MD Ioana Maria Lambrescu

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