Gastric Mixed Adenoneuroendocrine Carcinoma

o t ( o i a j t n g t t d p s o t r t astrointestinal mixed adenoneuroendocrine carcinomas MANECs) are rare tumors and, as the name implies, are haracterized by the presence of both components, exocrine nd neuroendocrine, each one representing at least 30% of he lesion.1 It is unclear if they originate from proliferation f different cell lineages or from stem cells capable of differntiating along multiple cell lineages. They may present as olypoid lesions, with variable size. Treatment and prognosis s determined by the more aggressive component.2 An 84-year-old woman was referred to upper gastroinestinal endoscopy for evaluation of dyspepsia. Endoscopic xamination showed a 15 mm polypoid lesion with central lceration in the anterior wall of gastric body and papuous gastropathy (Fig. 1). Biopsies of the gastric lesion howed a neuroendocrine tumor and random biopsies of he gastric mucosa showed chronic atrophic gastritis and ntestinal metaplasia. Serum antibodies to parietal cells and o intrinsic factor were negative. Serum level of chromoranin A level was 129.6 ng/mL (normal level < 80 ng/mL). horacic and abdominal CT revealed neither locoregional denopathies nor distant metastasis. Single-photon emision computed tomography showed no lesion with uptake