Korean J Gastrointest Endosc > Volume 42(4); 2011 > Article
Korean Journal of Gastrointestinal Endoscopy 2011;42(4): 236-240.
내시경 점막하 박리술로 진단된 상피하종양으로 발현한 위 신경내분비암 1예
백대현ㆍ김성환ㆍ정준영ㆍ손병관ㆍ조윤주ㆍ박영숙ㆍ이원미*
을지대학교 의과대학 내과학교실, *병리학교실
A Case of Neuroendocrine Carcinoma Presenting as a Subepithelial Tumor Diagnosed by ESD
Dae Hyun Baek, M.D., Seong Hwan Kim, M.D., Jun Young Jung, M.D., Byoung Kwan Son, M.D., Yunju Jo, M.D., Young Sook Park, M.D. and Won Mi Lee, M.D.*
Departments of Internal Medicine and *Pathology, Eulji University College of Medicine, Seoul, Korea
Abstract
A gastric neuroendocrine carcinoma is very rare, and the histological diagnosis is very difficult. These carcinomas result in a poor prognosis because they are preceded by severe lymphovascular invasion and early metastasis. In particular, it is difficult to distinguish between adenocarcinoma and neuroendocrine carcinoma by endoscopy when no specific symptoms are present (e.g., dyspepsia, nausea). According to published articles in Korea, most cases were diagnosed as adenocarcinoma initially; however, they were confirmed postoperatively as neuroendocrine carcinoma based on a histological examination using immunohistochemical staining. A case of a 55-year-old man, who had an incidental finding of a subepithelial tumor during his health check-up, was recommended for an endoscopic submucosal dissection (ESD). But the patient was lost to follow-up for 4 years. When he was examined again, the size of the tumor had increased from the previous exam. He underwent ESD and was diagnosed with a well-differentiated neuroendocrine carcinoma. (Korean J Gastrointest Endosc 2011;42:236-240)
Key Words: Carcinoma neuroendocrine, Subepithelial tumor, Endoscopic submucosal dissection
주요어: 신경내분비암, 상피하종양, 내시경 점막하 박리술
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