Synchronous Adenocarcinoma and Neuroendocrine Tumors of the Stomach

Introduction: Synchronous tumors of the stomach have been reported in a limited number of case reports in the literature. Gastric neuroendocrine tumors are uncommon and account for 0.3% of gastric neoplasms. The coexistence of adenocarcinoma and carcinoid tumors in the stomach is exceedingly rare. Presentation of Case: We report a rare case of two primary, histologically distinct, synchronous cancers of the stomach in a 70-year-old male. The patient presented for evaluation of a pre-syncopal episode. Lab data confirmed a normocytic/normochromic anemia with a hemoglobin of 6.6 g/d, hematocrit of 20.3%, and MCV of 86.1fL. An EGD was completed which demonstrated a 30 mm polypoid ulcerative mass in the gastric antrum and a 12 mm polyp in the gastric body. Pathological assessment confirmed adenocarcinoma and neuroendocrine (carcinoid) malignancies respectively. Conclusion: There have been limited case reports of patients with two separate, synchronous gastric malignancies. Additional reports of these cases would be necessary so appropriate screening and surveillance recommendations can be established, particularly if there is a coexistent history of autoimmune disease.