<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452024000600056</article-id>
<article-id pub-id-type="doi">10.1159/000536674</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm: An Unusual Tumor and Its Presentation in a Young Adult]]></article-title>
<article-title xml:lang="pt"><![CDATA[Neoplasia gástrica mista neuroendócrina e não-neuroendócrina (MiNEN): um tumor raro e a sua apresentação clínica num doente jovem]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carvalho]]></surname>
<given-names><![CDATA[Tânia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Coutada]]></surname>
<given-names><![CDATA[Andreia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jácome]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernandes]]></surname>
<given-names><![CDATA[Dália]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital de Braga Department of Gastroenterology ]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Português de Oncologia do Porto/Porto Comprehensive Cancer Centre Raquel Seruca Department of Pathology ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<volume>31</volume>
<numero>6</numero>
<fpage>56</fpage>
<lpage>60</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452024000600056&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452024000600056&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452024000600056&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Gastric cancer is the fourth most common cause of cancer death, with more than 90% of the cases being adenocarcinomas. Among the diverse subtypes, mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) is one of the rarest types. Gastric cancer can manifest with signi&#64257;cant bleeding in up to 5% of patients.  Case Presentation:  The authors present a case of a healthy 26-year-old male who experienced two episodes of major upper gastrointestinal bleeding that were resolved with endoscopic treatment. During the second endoscopy, a 15-mm nodular subepithelial lesion was identi&#64257;ed at the gastroesophageal junction. Endoscopic ultrasound revealed a homogeneous and hypoechoic lesion with well-de&#64257;ned limits in the deep mucosa. Histological examination of the biopsies showed an adenocarcinoma. The patient later underwent a distal esophagectomy and a total gastrectomy, followed by chemotherapy. Histological examination of the surgical specimen showed a mixed adenoneuroendocrine carcinoma composed of an ade nocarcinoma with tubular/glandular pattern and signet ring cells and a large cell-type neuroendocrine carcinoma. The neoplasia had in&#64257;ltrated the outer muscular layers of the stomach and had disseminated to 3 regional lymph nodes, leading to its classi&#64257;cation as stage IIb. Two years following the treatment, there is no evidence of recurrence. All genetic tests applied were negative.  Discussion:  A MiNEN occurs when both neuroendocrine and non-neuroendocrine components represent at least 30% of the lesion. Due to its rarity, epidemiology and standard treatment are not well established because most data published are from case reports. In this context, we present a compelling case study, highlighting the patient&#8217;s young age, the rarity of this speci&#64257;c cancer, and its uncommon presentation.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  O cancro gástrico é a quarta causa mais comum de morte por cancro, sendo, em mais de 90% dos casos, adenocarcinoma. Entre os vários subtipos de tumores gástricos, a neoplasia mista neuroendócrina e não-neuroendócrina (MiNEN) é dos mais raros. O cancro gástrico pode-se manifestar como hemorragia digestiva major em até 5% dos doentes.  Apresentação do caso:  Os autores apresentam o caso de um jovem saudável de 26 anos que se apresentou com dois episódios de hemorragia digestiva major tratadas endoscopicamente. Na segunda endoscopia observou-se uma lesão subepitelial nodular com 15 mm na junção esofagogástrica que, na ecoendoscopia, apresentava-se como uma lesão homogénea e hipoecóica, com limites bem de&#64257;nidos, na dependência da mucosa profunda. As biópsias da lesão revelaram presença de adenocarcinoma. O doente foi submetido a uma gastrectomia total com esofagectomia distal e, posteriormente, a quimioterapia. Na peça cirúrgica foi identi&#64257;cado um carcinoma misto adenoneuroendócrino composto por um adenocarcinoma com padrão tubular/glandular e células em anel de sinete e um carcinoma neurodendócrino de células grandes. O tumor invadia a camada muscular externa do estômago e apresentava 3 adenopatias locais, sendo classi&#64257;cado como estadio IIb. Após 2 anos de seguimento, não há sinais de recidiva. Todos os testes genéticos realizados foram negativos. Um MiNEN é de&#64257;nido pela presença de um componente neuroendócrino e um não-neuroendócrino, sendo que cada um representa, pelo menos, 30% da lesão. A epidemiologia e o tratamento mais adequado ainda não estão bem estabelecidos, dado que é um tumor raro e a maioria da informação disponível advém de casos clínicos. Neste contexto, os autores apresentam um caso clínico em que se destaca a idade jovem do doente, a raridade do tumor e e a sua apresentação incomum.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Gastric cancer]]></kwd>
<kwd lng="en"><![CDATA[Mixed neuroendocrine-non-neuroendocrine neoplasm]]></kwd>
<kwd lng="en"><![CDATA[Upper gastrointestinal bleeding]]></kwd>
<kwd lng="pt"><![CDATA[Cancro gástrico]]></kwd>
<kwd lng="pt"><![CDATA[Neoplasia mista neuroendócrina e não-neuroendócrina]]></kwd>
<kwd lng="pt"><![CDATA[Hemorragia digestiva alta]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sexton]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
<name>
<surname><![CDATA[Al Hallak]]></surname>
<given-names><![CDATA[MN]]></given-names>
</name>
<name>
<surname><![CDATA[Diab]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Azmi]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gastric cancer a comprehensive review of current and future treatment strategies]]></article-title>
<source><![CDATA[Cancer Metastasis Rev]]></source>
<year>2020</year>
<volume>39</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>1179-203</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="">
<collab>International Agency for Research on Cancer</collab>
<source><![CDATA[Cancer today: estimated number of new cases in 2020, worldwide, both sexes, all ages]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rawla]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Barsouk]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology of gastric cancer global trends, risk factors and prevention]]></article-title>
<source><![CDATA[Prz Gastroenterol]]></source>
<year>2019</year>
<volume>14</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>26-38</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zali]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Rezaei-Tavirani]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Vafaee]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Rezaei-Tavirani]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gastric cardia adenocarcinoma pathway analysis]]></article-title>
<source><![CDATA[Gastroenterol Hepatol Bed Bench]]></source>
<year>2013</year>
<volume>6</volume>
<numero>Suppl 1</numero>
<issue>Suppl 1</issue>
<page-range>S11-8</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[WHO classification of tumours editorial board, ed. Digestive system tumours]]></source>
<year>2019</year>
<volume>1</volume>
<edition>5th</edition>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carvão]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Dinis-Ribeiro]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pimentel-Nunes]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Libânio]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neuroendocrine tumors of the gastrointestinal tract a focused review and practical approach for gastroenterologists]]></article-title>
<source><![CDATA[GE Port J Gastroenterol]]></source>
<year>2021</year>
<volume>28</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>336-48</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mansfield]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical features, diagnosis, and staging of gastric cancer]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Tanabe]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Kruskal]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[UpToDate]]></source>
<year>2021</year>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vasas]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Wiggins]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Chaudry]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bryant]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hughes]]></surname>
<given-names><![CDATA[FS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Emergency presentation of the gastric cancer; prognosis and implications for service planning]]></article-title>
<source><![CDATA[World J Emerg Surg]]></source>
<year>2012</year>
<volume>7</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>31</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bao]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Rao]]></surname>
<given-names><![CDATA[Q]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Shen]]></surname>
<given-names><![CDATA[Q]]></given-names>
</name>
<name>
<surname><![CDATA[Wei]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinicopathological features and prognosis of gastric mixed adenoneuroendocrine carcinoma]]></article-title>
<source><![CDATA[Int J Clin Exp Pathol]]></source>
<year>2018</year>
<volume>11</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1499-509</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Zhou]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Tian]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[He]]></surname>
<given-names><![CDATA[Q]]></given-names>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparison of survival and patterns of recurrence in gastric neuroendocrine carcinoma, mixed adenoneuroendocrine carcinoma, and adenocarcinoma]]></article-title>
<source><![CDATA[JAMA Netw Open]]></source>
<year>2021</year>
<volume>4</volume>
<numero>7</numero>
<issue>7</issue>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guragain]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Guddati]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Zahid]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Hertan]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mixed adenoneuroendocrine tumor of stomach (MANEC) a rare tumor]]></article-title>
<source><![CDATA[Am J Gastroenterol]]></source>
<year>2017</year>
<volume>112</volume>
<page-range>1408</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barrett]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Rendell]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Pokrzywa]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Lopez-Aguiar]]></surname>
<given-names><![CDATA[AG]]></given-names>
</name>
<name>
<surname><![CDATA[Cannon]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Poultsides]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Adjuvant therapy following resection of gastroenteropancreatic neuroendocrine tumors provides no recurrence or survival benefit]]></article-title>
<source><![CDATA[J Surg Oncol]]></source>
<year>2020</year>
<volume>121</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>1067-73</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[La Rosa]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Marando]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sessa]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Capella]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mixed adenoneuroendocrine carcinomas (MANECs) of the gastrointestinal tract an update]]></article-title>
<source><![CDATA[Cancers]]></source>
<year>2012</year>
<volume>4</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>11-30</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Savides]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Jensen]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gastrointestinal bleeding]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Feldman]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Friedman]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Brandt]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Sleisenger and fordtran's gastrointestinal and liver disease]]></source>
<year>2021</year>
<edition>11th</edition>
<page-range>283-95</page-range><publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Han]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Shi]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Qian]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Ding]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of endoscopic ultrasound on the preoperative T staging of gastric cancer a retrospective study]]></article-title>
<source><![CDATA[Medicine]]></source>
<year>2016</year>
<volume>95</volume>
<numero>36</numero>
<issue>36</issue>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dhupar]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Rice]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Correa]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Weston]]></surname>
<given-names><![CDATA[BR]]></given-names>
</name>
<name>
<surname><![CDATA[Bhutani]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Maru]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Endoscopic ultrasound estimates for tumor depth at the gastroesophageal junction are inaccurate implications for the liberal use of endoscopic resection]]></article-title>
<source><![CDATA[Ann Thorac Surg]]></source>
<year>2015</year>
<volume>100</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1812-6</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
