A case of type 3 gastric neuroendocrine tumor with detailed endoscopic examination before treatment

A 41-year-old man was referred to our hospital for further examination of a tumor in the stomach. Esophagogastroduodenoscopy (EGD) showed a submucosal tumor-like elevated tumor of 2.5 cm in diameter with a reddish deep depression at the lower body of the stomach. In addition, magnified narrow-band imaging showed dilated vessels at the marginal elevated area and a large villous structure and small vessel without change of caliber at the central depressed area of the tumor. The tumor was diagnosed as a neuroendocrine tumor (NET) by endoscopic biopsy. Endoscopic findings including the dilated blood vessels were useful for the correct diagnosis. Computed tomography (CT) detected a swollen lymph node of 6.9 cm in diameter located close to the tumor. Because the tumor was a sporadic type in a patient without underlying diseases, this tumor was diagnosed as type 3 gastric NET. Therefore, we performed distal gastrectomy with lymph node dissection. The pathological diagnosis was NET (G2), pT3N1M0, pStage b (ENETS). No recurrence has occurred for 24 months after surgery.