Published online Dec 14, 2015. doi: 10.3748/wjg.v21.i46.13195
Peer-review started: February 9, 2015
First decision: April 24, 2015
Revised: June 2, 2015
Accepted: August 28, 2015
Article in press: August 31, 2015
Published online: December 14, 2015
Processing time: 305 Days and 20.9 Hours
Gastric neuroendocrine tumors are rare; however, the incidence has recently increased due to the increasing use of upper endoscopy. Neuroendocrine tumors arise from the excess proliferation of enterochromaffin-like (ECL) cells. The proliferative changes of enterochromaffin cells evolve through a hyperplasia-dysplasia-neoplasia sequence that is believed to underlie the pathogenesis of gastric neuroendocrine tumors. Endoscopic resection is recommended as the initial treatment if the tumor is not in an advanced stage. However, there is no definite guideline for the treatment of recurrent gastric neuroendocrine tumors following endoscopic resection. Here, we report a rare case of gastric neuroendocrine tumors in a 56-year-old male who experienced two recurrences within 11 years after endoscopic resection. The patient finally underwent a total gastrectomy. The pathological features of the resected stomach exhibited the full hyperplasia-dysplasia-neoplasia sequence of the ECL cells in a single specimen.
Core tip: This rare case exhibited the full hyperplasia-dysplasia-neoplasia sequence of enterochromaffin-like cells in a single specimen. This case clarifies the pathogenesis of gastric neuroendocrine tumors. Furthermore, this case revealed that total gastrectomy is a treatment option for patients with recurrent neuroendocrine tumors following excision.