A case of synchronous association of stomach neuroendocrine tumor and pernicious anemia

Ghada Sabbagh; Hamza Elfekih; Ghachem Aycha; Ghada Saad; Kenza Houd; Ach Taieb; Abdelkarim Asma Ben; Yosra Hasni; Chaieb Molka Chadli

doi:10.1530/endoabs.90.EP627

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Endocrine Abstracts (2023) 90 EP627 | DOI: 10.1530/endoabs.90.EP627

ECE2023 Eposter Presentations Endocrine-related Cancer (80 abstracts)

A case of synchronous association of stomach neuroendocrine tumor and pernicious anemia

Ghada Sabbagh ^1,2 , Hamza Elfekih ^1,2 , Ghachem Aycha ^1,2 , Ghada Saad ^1,2 , Kenza Houd ^1,2 , Ach Taieb ^1,2 , Asma Ben Abdelkarim ^1,2 , Yosra Hasni ^1,2 & Molka Chadli Chaieb ^1,2

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Author affiliations

¹Farhat Hached Hospital, Endocrinology and Diabetology, Sousse, Tunisia; ²Faculty of Medicine Ibn Al Jazzar, University Of Sousse, Sousse, Tunisia.

Introduction: Biermer’s disease is a chronic inflammatory disease due to antibodies targeting parietal cells and intrinsic factor compromising vitamin B12 absorption leading to pernicious anemia, and gastric acid secretion leading to achlorhydria. Neuroendocrine tumors are rare neoplasms that have been reported during the evolution of chronic gastritis. We here describe a case of a type 1 gastric neuroendocrine tumor discovered alongside with Biermer’s disease.

Case presentation: A 60-year-old patient with no medical history was first diagnosed with anemia. Hemoglobin levels were initially at 9 g/dl with macrocytosis, low levels of vitamin B12 and presence of intrinsic factor antibodies. Since the diagnosis of Biermer’s disease was made, a lifetime vitamin B12 supplementation was prescribed. A gastroscopy was performed showing a 4 mm polyp in the gastric mucosa. Histopathology revealed a type 1 stomach neuroendocrine tumor. Since the tumor is well differentiated and nonfunctioning tumor, our decision was to follow up the patient and to monitor him by gastroscopic surveillance.

Discussion: Type 1 neuroendocrine tumors are known to occur in the setting of chronic autoimmune gastritis. Deprived gastric acid secretion due to parietal cell destruction results into continuous gastrin secretion leading to hyperplasia of both G cells and enterochromaffin like cells that could further induce gastric neuroendocrine tumors. Synchronous association of stomach neuroendocrine tumor and Biermer’s disease is possible and clinicians should be aware of that.