# A Case of Gastric Neuroendocrine Tumor With a Raspberry‐Like Appearance on the Background of Acid‐Suppressive Therapy‐Related Gastropathy

## TL;DR

A rare case of a gastric neuroendocrine tumor with a raspberry-like appearance is reported in a patient on long-term acid-suppressive therapy.

## Contribution

This case highlights the association between acid-suppressive therapy-related gastropathy and gastric neuroendocrine tumors with raspberry-like morphology.

## Key findings

- A 52-year-old man with a history of acid suppressive therapy was found to have a grade 1 neuroendocrine tumor with raspberry-like appearance.
- Endoscopic submucosal dissection successfully removed the tumor with negative margins and no vascular invasion.
- Gastric neuroendocrine tumors with raspberry-like morphology are rare and should be considered in the differential diagnosis.

## Abstract

We report the case of a 52‐year old man who was referred to our institution after a routine health check identified an asymptomatic gastric polyp. The medical history of the patient included reflux esophagitis, for which he had been treated with vonoprazan 10 mg daily for 6 years after initially receiving proton pump inhibitors. Endoscopy revealed a 4‐mm, hemispherical, uniformly reddish Yamada type II lesion on the anterior wall of the gastric body, arising from nonatrophic mucosa with multiple small hyperplastic polyps. Magnifying narrow‐band imaging revealed a regular microvascular and microsurface pattern, producing a raspberry‐like appearance. Histological examination of the biopsy specimen revealed a grade 1 neuroendocrine tumor. Contrast‐enhanced computed tomography revealed no evidence of metastatic lesions. En bloc resection was successfully performed using endoscopic submucosal dissection. Pathological examination confirmed a 5‐mm grade 1 neuroendocrine tumor with negative margins and no vascular invasion. Gastric neuroendocrine tumors with raspberry‐like morphology are rare. This case underscores the importance of considering gastric neuroendocrine tumors in the differential diagnosis of raspberry‐like gastric lesions, particularly in patients with potent acid‐suppressive therapy–related gastropathy.

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