Our experience on the treatment of rare malignant primary and secondary gastric tumours

The reduced incidence of gastric cancer, due to a better patients surveillance and more accurate understanding of prophylactic measure, has allowed a detection of early stages as well as cancers with different origin cells. Either the difficulty of differential diagnosis or the various surgical and integrated approaches, make these neoplasm hard to enroll in standard treatment protocols. Our experience consists of 5 clinical cases with four different histology: lymphoma, leiomioma, carcinoid and gastrinoma. A rare case of secondary involvement of the stomach by an adrenal adenocarcinoma is also described. Lymphomas benefit of the surgical therapy only in early stages (IE, IIE), eventually associated to chemio- and radiotherapy in relationship with local diffusion of the disease; gastric resection is more supported than gastrectomy. Polichemotherapy, with or without radiotherapy is used for advanced stages (HIE and IVE), leaving to surgery the role of controlling hemorrhagic or occlusion complicances. GIST have a different therapeutic approach: surgery represents the only choice since chemio- and radiotherapy have no beneffts for the biological characteristics of such neoplasm. Surgery is the ideal choice for the carcinoids with some indications for chemio o radiotherapy in the palliative surgery or in the relapsing. We emphasize the rarity of the secondary gastric neoplasm coming from the suprarenal glands. We analyze our diagnostic and therapeutic protocols, comparing them with the current literature.