Details

Autor(en) / Beteiligte

• Jianu, Constantin S
• Lange, Ove J
• Viset, Trond
• Qvigstad, Gunnar
• Martinsen, Tom C
• Fougner, Reidun
• Kleveland, Per M
• Fossmark, Reidar
• Hauso, Øyvind
• Waldum, Helge L

Titel

Gastric neuroendocrine carcinoma after long-term use of proton pump inhibitor

Ist Teil von

• Scandinavian journal of gastroenterology, 2012-01, Vol.47 (1), p.64-67

Ort / Verlag

Colchester: Informa Healthcare

Erscheinungsjahr

2012

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract We present a case of a gastric neuroendocrine carcinoma in a patient with a history of long-term proton pump inhibitor (PPI) use. A 49-year-old man using PPI for the last 15 years due to gastroesophageal reflux disease developed progressive dysphagia, dyspepsia and weight loss. Upper gastrointestinal endoscopy, endoscopic ultrasonography and abdominal CT diagnosed a malignant tumor localized to a hiatal hernia. Fasting serum chromogranin A and gastrin concentrations were elevated (32 nmol/l and 159 pmol/l, respectively). Helicobacter pylori PCR analysis of antral biopsies was negative. Biopsies from endoscopically normal oxyntic mucosa showed enterochromaffin-like (ECL) cell hyperplasia. Tumor biopsies revealed a poorly differentiated neuroendocrine carcinoma. Sevier-Munger staining, immunohistochemistry and electron microscopy indicated ECL cell as origin of the tumor cells. Concerns have previously been raised about the safety of long-term PPI use due to a possible increased risk of cancer. This case illustrates a patient with a poorly differentiated neuroendocrine carcinoma with ECL cell characteristics probably induced by hypergastrinemia secondary to long-term PPI use.