Type 1 Gastric Neuroendocrine Tumor Found on Endoscopic Polypectomy

An unusual association of folic acid deficiency with gastric neuroendocrine tumor type I

The association of gastric neuroendocrine tumour type I with macrocytic anaemia due to vitamin B12 deficiency is commonly encountered. The etiological cause of macrocytic anaemia must always be precisely established for the subsequent treatment guidance. We present the case of a 63-year-old patient admitted for marked physical asthenia, palpitations, abdominal pain, flatulence, paresthesia in the upper and lower limbs and concentration difficulties. Clinical examination revealed pale, dry skin, Hunter's glossitis, and tachycardic heart sounds. Bloodwork showed pancytopenia with macrocytic normochromic anaemia, vitamin B12 within normal limits, but with low folic acid levels. The reticulocyte crisis was documented on day three after initiating folic acid treatment. Exploration by upper digestive endoscopy and colonoscopy described multiple polypoid tumours in the greater curvature of the stomach. The histopathological and immunohistochemical examination lead to the diagnosis of gastric neuroendocrine tumours (NET) type G1. To our knowledge, there are no reports about an association of this type of tumour with folate deficiency-induced anaemia.

Gastric Neuroendocrine Tumor

Gastric neuroendocrine tumor (gNET) is a rare carcinoid of the stomach whose incidence is increasing due to widespread use of upper gastrointestinal endoscopy (UGIE). There are four types of gNETs with different management strategies and prognosis. Here, we present a patient who came with abdomen pain and intermittent melena. UGIE showed a sessile polyp in the stomach. The patient subsequently underwent polypectomy and was symptomatically relieved.