Lymph node metastasis from gastric carcinoid tumors occurring concomitantly with gastric adenocarcinomas and atrophic gastritis

We describe a case of gastric carcinoids concomitant with gastric adenocarcinoma in a 50-year-old woman affected by atrophic gastritis. Number and size of the lesions, pathological examinations, and underlying gastric disease all indicated low-risk carcinoids. Nevertheless, when R1 gastrectomy was carried out, an unsuspected lymph node metastasis from carcinoid was found along the lesser curvature. The same occurrence is reported in several cases of the literature, which suggests that the association of gastric carcinoid to adenocarcinoma could point to the malignant nature of carcinoid, apart from underlying gastric disease and tumor characteristics.