Gastric Neuroendocrine Carcinoma Presenting as Ascites in a Young Female

Although neuroendocrine tumors (NETs) can occur in any organ, the majority of them occur in the gastrointestinal (GI) tract. We present the case of a 27-year-old female who presented with ascites. She underwent an ascitic fluid analysis, an esophagogastroduodenoscopy (EGDscopy) with biopsies, and a positron emission tomography (PET) scan, all of which culminated in a diagnosis of a poorly differentiated gastric NET (small cell type) with peritoneal metastasis. She was treated with cisplatin and etoposide. Depending on the differentiation and grade, NETs can manifest in a variety of ways. Definitive diagnosis requires histopathological examination and immunostaining. For smaller well-differentiated NETs, management is either endoscopic or surgical resection. For neuroendocrine carcinomas with metastasis, chemotherapy and symptomatic management are advised. This case report highlights the rare presentation of a neuroendocrine carcinoma as well as discusses its diagnostic approach and possible treatment options.