A 56-year-old man with advanced gastric tumor in the pyloric antrum had multiple lymph node metastases(lymph nodes #5, 6, 8, and 13), as revealed by abdominal computed tomography(CT).The patient was diagnosed with coexisting clinical Stage III A gastric cancer(cT2[SS], cN2, cM0)with concomitant malignant lymphoma.Distal gastrectomy, D2 lymph node dissection, and resection of lymph node #13 were performed.Histopathological findings indicated that both the primary tumor and lymph node metastases were neuroendocrine carcinomas.Adjuvant chemotherapy with S-1 was administered; however, follow-up CT after 6 months revealed local recurrence around the celiac artery.Therefore , the chemotherapy regimen was changed to irinotecan and cisplatin.A clinical complete response was obtained after 6 chemotherapy courses and maintained for up to 45 months.The patient is alive at 60 months after the operation.