Batna Journal of Medical Sciences
Volume 13, Numéro 1, Pages 1-6
2026-05-01
Well-differentiated Grade 3 Gastric Neuroendocrine Tumors: Diagnostic Challenges And Therapeutic Perspectives
Authors : Kassama Zakia . Zerrouk Dalal . Hamdouche Souad . Benmamar Hichem Elazhari . Chehad Mohamed Nour .
Abstract
The most common digestive neuroendocrine tumors (NETs) arise from the small intestine, pancreas, or appendix, followed by those originating in the stomach. Among these, type 1 gastric neuroendocrine tumors (g-NETs) generally have a favorable prognosis due to their low proliferative activity. However, a recently identified entity, well-differentiated grade 3 neuroendocrine tumors, is characterized by preserved morphological differentiation with an elevated Ki-67 proliferation index. These tumors represent a borderline entity between low-grade NETs and neuroendocrine carcinomas (NECs). Although extremely rare, their management remains controversial and challenging, particularly in cases where cytotoxic chemotherapy is contraindicated or declined. We report the case of a 51-year-old female patient diagnosed with a well-differentiated, yet aggressive, high-grade gastric neuroendocrine tumor (type 1) arising in the context of autoimmune gastritis. The tumor exhibited a Ki-67 proliferation index of 25%, indicative of significant metastatic potential. A hepatic metastasis was identified at diagnosis. Treatment with lanreotide achieved a prolonged partial response, enabling consideration of delayed surgical intervention.
Keywords
Gastric neuroendocrine tumor ; Well-differentiated ; Grade 3 ; Autoimmune gastritis
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