Poorly Differentiated Carcinomas of the Foregut (Gastric, Duodenal and Pancreatic)

clear in the older literature.Due to the rarity of gastrointestinal PDEC, comprehensive studies are still lacking on the epidemiology, clinical presentation, genetic alterations, histopathology, natural history and treatment of these tumors.Our knowledge of gastrointestinal PDEC is therefore limited and mainly based on a small series of patients and case reports.Primary small cell carcinoma of the stomach was first described in 1976 [2] .So far, more than 100 cases of gastric small cell carcinomas have been reported [3] .PDECs of the stomach account for approximately 6% of gastric endocrine tumors [4] .Males are more frequently affected than females (M:F ratio 3: 1) and the mean age at diagnosis is 64 years [3,5] .Most patients have regional or distant metastases at presentation and lack hormone overproduction syndrome.The clinical outcome is poor, with death due to tumor disease within 12 months of the di-