GOJ mass, older patient.
@ZHOUSEH @MattieFarzin @pembeoltulu @RunjanChetty @ariella8 @Dr_Brian_Cox @ALBoothMD @DrBMcGinn @DrGeeONE @MAHoureih @TheKarenPinto
#GIpath #PathTwitter #Surgpath
Further Hx for @Meghna0630
Male,
PMHx: skin cancer, DM type2, BPH
Presents with SBO. Nodule in stomach and small bowel (below).
CK20 (both sites)
CK7
TTF-1
TTF-1 from SB nodule
Ki67
Final bits of Hx
GOJ mass--> large, extends in oesophagus.
No lung masses on imaging.
I have made this a bit of Hx difficult to directly access, to simulate finding Hx IRL...
Diagnosis:
Gastric neuroendocrine (small cell) carcinoma with metastasis to small bowel.
1/ Neuroendocrine carcinomas of the stomach are rare and only account for 1% of all gastric carcinomas.
2/ They are horrible and aggressive cancers than have a prognosis.
pubmed.ncbi.nlm.nih.gov/29895024/
3/ TTF-1 can be expressed in gastric (and many other) small cell carcinomas and is not a reliable marker for lung mets.
pubmed.ncbi.nlm.nih.gov/26469324/
4/ Recent studies show these tumours show different mutations compared with conventional gastric adenocarcinomas, including CPLX2 aka Complexin 2 (?future biomarker).
pubmed.ncbi.nlm.nih.gov/28239029/
5/ Lastly, Merkel cell polyomavirus has been detected in this case report below (not this case) of small cell carcinoma, so primary gastric Merkel cell carcinoma anyone?
pubmed.ncbi.nlm.nih.gov/24709111/
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