Neuroendocrine carcinoma of stomach causing gastric outlet obstruction: a diagnostic dilemma

Gastric neuroendocrine tumour (GNET), also known as carcinoids, are a very rare cause of gastric outlet obstruction and arise from entero-chromaffin like cells the mucosa. They account for 0.2/1000001 population 8.7% all Gastrointestinal carcinoids. four types based on degree differentiation, cell origin other pathologic features. Type 4 GNET referred to carcinoma accounting <1% GNET. aggressive, poorly differentiated, locally invasive tumours with metastatic potential. Hence, they require an aggressive approach in terms surgery multimodality adjuvant treatment. Our patient is elderly hypertensive who had complaints projectile vomiting over ten days associated weight loss last two years. A diagnosis was made, she underwent contrast CT scan endoscopy twice, both being suggestive malignancy involving antrum region however, endoscopic biopsy showed unremarkable histology. Subsequently, emergency laparotomy which there hard growth palpable distal gastrectomy, D1 lymphadenectomy gastrojejunostomy were done. Post-op HPE carcinoma, thus, depicting our difficulty pre-op report given its rarity.