LAUSR

801 tumors posing a low risk of malignancy, where‐ as type III neoplasm has a poor prognosis, and type IV neoplasm—an extremely poor progno‐ sis with a mean survival time of several months. We present a case of a 65 ‐year ‐old female kid‐ ney transplant recipient treated with triple im‐ munosuppressive therapy (prednisolone, cyclo‐ sporine, and mycophenolate mofetil), with end‐ ‐stage renal disease of her own kidneys due to diabetic nephropathy, with hypertension, and a history of cytomegalovirus infection, who was incidentally diagnosed with asymptomat‐ ic neuroendocrine tumor of the gastric antrum 25 months after transplant. Routine endosco‐ py was performed and showed the granular, er‐ ythematous pattern of the mucous membrane in the antrum (FIGURE 1A and 1B). Features of low‐ ‐grade neuroendocrine tumor were found on histopathological examination, with a mitotic index below 1 mitosis / 10 high ‐power fields, and 70% of the section volume was involved, with infiltrated margins of the specimen slice. Additionally, traits of chronic atrophic gastri‐ tis with intestinal metaplasia were detected (FIGURE 1C and 1D). The patient denied having any symptoms. Neuroendocrine neoplasms are rare tumors (2.89 to 6.98 cases per 100 000 people per year in the United States)1,2 originating from neuro‐ endocrine cells (neural crest, neuroendocrine is‐ lets, and stem cells), with a rising incidence dur‐ ing several past decades. This type of tumors can be benign or malignant and may develop in var‐ ious organs, particularly in the gastrointestinal and pulmonary systems. One of their subtypes, gastric neuroendocrine tumors, account for 1 to 2 cases per 1 million per‐ sons per year and represent 8.7% of all gastroin‐ testinal neuroendocrine tumors.3,4 They originate from enterochromaffin ‐like cells of the gastric mucosa or, less commonly, from other types of endocrine cells (that se‐ crete serotonin, gastrin, or adrenocorticotrop‐ ic hormone).4 Patients may develop symptoms of uncontrolled hormone secretion or caused by tumor invasion. Prognosis and survival depend on the type of tumor. There is a classification distinguish‐ ing 4 tumor types, based on their histological and morphological characteristics and patho‐ genesis.4 Well ‐differentiated type I and II gastric neuroendocrine neoplasms are mostly benign CLINICAL IMAGE