Carcino´d tumor revealing pernicious anemia
Neirouz Ghannouchi Jaafoura, Ahlem Braham Krifa
The Pan African Medical Journal. 2014;19:153. doi:10.11604/pamj.2014.19.153.4326

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Carcino´d tumor revealing pernicious anemia

Cite this: The Pan African Medical Journal. 15/10/2014 ;19:153. doi:10.11604/pamj.15/10/2014 .19.153.4326

Received: 06/04/2014 - Accepted: 04/10/2014 - Published: 15/10/2014

Key words: Carcinoïd tumor, pernicious anemia, atrophic gastritis

© Neirouz Ghannouchi Jaafoura et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Corresponding author: Neirouz GhannouchI Jaafoura, Departement of Internal Medicine, Farhat Hached Hospital, Sousse, Tunisia (

Carcino´d tumor revealing pernicious anemia


Neirouz Ghannouchi Jaafoura1, &, Ahlem Braham Krifa2


1Department of Internal Medicine, Farhat Hached Hospital, Sousse, Tunisia, 2Department of Gastro-EntÚrology, Sahloul Hospital, Sousse, Tunisia



&Corresponding author
Neirouz GhannouchI Jaafoura, Department of Internal Medicine, Farhat Hached Hospital, Sousse, Tunisia



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Endocrine tumors (ET) of the digestive tract are rare. Gastric carcinoid was the most common form of gastrointestinal ET's. It is a rare complication of pernicious anemia but may reveal the disease. We report the case of a 57-year- old women, wich is referred for exploration of epigastric pain with persistent dyspepsia. Gastroscopy found polypoids lesions (A) and gastric mucosae was enlarged, on histological study, by a well-circumscribed neoplastic proliferation covered by intact surface epithelium (B et C). Tumor cells have central, uniform nuclei, a low mitotic rate and co-express cytokeratine and chromogranine A, concluding to well-differentiated neuroendocrine tumor. Pallor on examination led us to perform NFS showing aregenrative anemia (hemoglobin at 7.2 g/dl) with high mean corpuscular volume and megaloblastosis in myelogram. Serum vitamine B 12 level is 60 pg /l and homocysteine level is 57 Ámol/l. Vitamin replacement treatment is given as well as endoscopic resection of polyps since assessment of extension is negative. The onset of pernicious anemia is difficult to establish because of its insidious presentation. This slow progression of vitamine B 12 deficiency, resulting from advanced autoimmune atrophic gastritis, explains the adaptation to anemic syndrome that does not represent the main complaint in this patient. This case confirm the importance of endoscopic evaluation at the diagnosis of pernicious anemia.



Figure 1: (A) polypoid lesions on stomach; (B) neoplastic proliferation on gastric mucosae; (C) tumor cells have central, uniform nuclei and a low mitotic rate







































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Carcinoïd tumor
Pernicious anemia
Atrophic gastritis

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