• Xiaolong Zhu, Haiyan Jing, and Takashi Yao.
• Department of Cardiac Surgery.
• Medicine (Baltimore). 2019 Jul 1; 98 (30): e16638.

IntroductionGastric neuroendocrine carcinoma (NEC) is rare. It is considered to be aggressive and has a poor prognosis since the diagnosis is usually made at its advanced stage. However, the survival rate is increased in some early gastric NECs. This study showed a case and reviewed the clinical characteristics of early NECs in stomach.Patient ConcernsA 38-year-old man displayed no symptoms and underwent the gastric endoscopy test for his health examination, which showed a red slightly depressed lesion 1.0 cm in size on the lesser curvature of gastric cardia. Magnifying endoscopy with narrow-band imaging (NBI) revealed a clear demarcation and an irregular mesh in vessels within the depressed area. The background mucosa was negative for atrophic gastritis and Helicobacter Pylori infection. A contrast-enhanced computed tomography (CT) scan disclosed no obvious thickening of stomach and lymphadenopathy. Blood tests and physical examination were unremarkable. He had not received any surgical treatment and denied a family history of cancer and any genetic disorders. The pathologic result of biopsy from the lesion was suspicious of superficial carcinoma. Then endoscopic submucosal dissection (ESD) was performed.DiagnosisGastric NEC G3 in the early stage (T1aN0M0).InterventionsConcerning this patient's situation, we considered the ESD as a curable treatment. And no radical surgery or adjuvant chemotherapy was arranged.OutcomesThe patient is doing well and displays no recurrence for 11 months, who is still in follow-up.Lessons Subsections As Per StyleThe early diagnosis and effective treatment by endoscopy would contribute to improve the prognosis of gastric NECs.

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