Autopsy and Case Reports
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Huge recurrent gastric neuroendocrine tumor: a second-line chemotherapeutic dilemma

Maria João Marques Ribeiro; Teresa Alonso; Pablo Gajate; Javier Molina; Arantzazu Barquin; Cristian Perna; Enrique Grande

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Chemotherapy is considered “state of the art” for the treatment of poorly differentiated neuroendocrine neoplasms. Unfortunately, there is no standard effective post-first-line treatment for relapsing high-grade gastroenteropancreatic neuroendocrine neoplasms. We report the case of a patient with a gastric neuroendocrine carcinoma stage IV, with massive gastrointestinal bleeding at diagnosis. After the first line of platin-based chemotherapy a major tumoral response was documented, but the patient relapsed after 4 months. A second line of chemotherapy treatment was given, with the FOLFOX regimen, and the patient has been free of progression for almost 2 years. There is no second-line standard treatment accepted for this type of carcinoma, but 5-fluorouracil combined with oxaliplatin showed interesting antitumor activity.


Carcinoma, Neuroendocrine, Stomach Neoplasms, Neoplasm Metastases, Medical Oncology


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