A case of neuroendocrine tumor G1 with unique histopathological growth progress

A gastric neuroendocrine tumor (NET) is generated from deep within the tissue mucosal layers. In many cases, NETs are discovered as submucosal tumor (SMT)-like structures by forming a tumor mass. This case has a clear mucosal demarcation line and developed like a polyp. A dilated blood vessel was found on the surface. The mass lacked the yellow color characteristic of NETs, and a SMT-like form was evident. Therefore, a nonspecific epithelial lesion was suspected and we performed endoscopy with magnifying narrow-band imaging (M-NBI). However, this approach did not lead to the diagnosis, as we diagnosed the lesion as a NET by biopsy examination. The lesion was excised by endoscopic submucosal dissection. The histopathological examination proved that the lesion was a polypoid lesion although it was also a NET because the tumor cells extended upward through the normal gland ducts scatteredly. To our knowledge, there is no previous report of NET G1 with such unique histopathological growth progress and macroscopic appearance shown by detailed examination using endoscopy with M-NBI.