ECE2018 ePoster Presentations Adrenal and Neuroendocrine Tumours (28 abstracts)
Gastric NET due to atrophic gastritic combined with multiglandular syndrom type 3
Dimitra Tampouratzi 1 , Konstantinos Papatheodorou 2 , Olga Tzaida 3 , Aggeliki Sapera 1 , Styliani Kalaitzidou 1 , Aspasia Drosou 1 , Fotini Kanouta 1 , Eleni Triantafillou 1 , Michalis Kotis 1 , Taxiarchis Kyrimis 1 , Georgios Papapdakis 4 , Anna Drakopoulou 1 , Victoria Kaltzidou 1 , Eirini Veniou 1 , Chrysa Karavasili 1 , Ginno Vecchini 3 , Athanasia Tertipi 1 & Dimitrios Nikolakis 2
1Endocrinology Department, Metaxa Anticancer Hospital, Piraeus, Greece; 2Gastroenterology Department, Metaxa Anticancer Hospital, Piraeus, Greece; 3Pathology Department, Metaxa Anticancer Hospital, Piraeus, Greece; 4STEPS Stoffwechselzentrum, Biel/Bienne, Switzerland.
Introduction: Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine and nervous systems. They most commonly occur in the intestine and are graded histologically according to markers of cellular proliferation. G1 and G2 neuroendocrine neoplasms are called neuroendocrine tumors (NETs) – formerly called carcinoid tumors. G3 neoplasms are called neuroendocrine carcinomas (NECs).
Objectives: We present a case of a patient with NET G1, type 1 with atrophic gastritis and multiple autoimmune diseases.
Methods: A 75-year-old woman underwent colonoscopy for anemia evaluation. The endoscopic biopsy revealed a low-grade gastric NET G1, 0.9 cm in the body of the stomach, with positive immunohistochemical staining for chromogranin (Cg). Serum gastrin was elevated up to 385 μU/ml (Ref. 28–185) and serum chromoganin-A was 6.1 nmol/l (Ref<3). The tumor was endoscopically removed.
Results: The patient was also suffering from Hashimoto thyroiditis and hypothyroidism, atrophic gastritis, megaloblastic anemia, vitiligo and rheumatoid arthritis. The biochemical and radiologic evaluation for MEN-1 syndrome was negative. The patient had positive Islet Cell Autoantibodies (ICA) and Glutamic Acid Decarboxylase Autoantibodies (GAD65) and negative antiadrenal antibodies, and she was diagnosed with polyglandular syndrome Type 3 with gastric NET. Three months later the patient underwent a white light endoscopy. The gastric biopsies revealed: atrophic gastritis with intestinal metaplasia and possible microcarcinoids in the body of the stomach. Pathology report revealed linear and nodular hyperplasia of neuroendocrine cells, positive for chromogranin and synaptophysin staining, but not NET. The further follow-up of the patients included regular gastroscopy control and clinical and laboratory evaluation for possible appearance of autoimmune diabetes or adrenal insufficiency.
Conclusions: Patients with atrophic gastritis can develop gastric NET due to hypergastrinemia. Further diagnostic control for autoimmune diseases should be performed for the early detection of a possible multiglandular syndrome, as well as possible autoimmune diabetes and adrenal insufficiency.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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