Amphicrine Carcinoma of the Duodenum: A Rare Entity

Abstract

Amphicrine carcinoma, in which endocrine and epithelial cell constituents are present within the same cell, is very rare. It is different from adenocarcinoma and Mixed Neuroendocrine-Non neuroendocrine neoplasms (MiNEN). In the current World Health Organisation (WHO) classification of gastrointestinal tumours, the only mention of an amphicrine tumour is in the form of Goblet Cell Adenocarcinoma (GCA) in the appendix, which has both neuroendocrine and non neuroendocrine characteristics in the same cell. Authors hereby report the case of a 63-year-old female who presented with complaints of abdominal pain of a six-month duration. Endoscopy showed a polypoidal lesion in the duodenum. Distal radical gastrectomy was done. Microscopy of the lesion showed atypical signet-ring-like cells and goblet-like mucinous cells with fine granular chromatin. On immunohistochemistry, the tumour cells were positive for CK7, synaptophysin, and chromogranin. The cells showed Periodic Acid-Schiff stain (PAS) positive, diastase-resistant material in the cytoplasm. These cells also showed mucicarmine positivity. Considering the biphenotypic nature of tumour cells, the diagnosis of amphicrine carcinoma was given. Amphicrine carcinomas have unique features in histopathology, immunohistochemistry, special stains, and genetic profile.

Keywords

• biphenotypic nature
• goblet cell adenocarcinoma
• mixed neuroendocrine nonneuroendocrine neoplasm