Clinical features and management of type I gastric carcinoids

Abstract

Type I gastric carcinoids (TIGCs) are related to chronic atrophic gastritis and are characterized by hypergastrinemia and hyperplasia of enterochromaffin-like cells. TIGCs are the most frequently diagnosed of all gastric carcinoids, accounting for about 70-80 %. Endoscopically, TIGCs are present as small (\10 mm), polypoid lesions or, more frequently, as smooth, rounded submucosal lesions. Histologically, TIGCs arise in the deep mucosa, with some invading the submucosa. Most TIGCs are well-differentiated tumors, with metastasis being rare. Therefore, patients with TIGCs generally have an excellent prognosis. Among the currently available treatment options are total gastrectomy, partial resection, antrectomy, endoscopic resection, and endoscopic surveillance, although no consensus has been reached on their optimal management. Further studies are needed to develop better management options for patients with TIGC.

Clinical features and outcomes of gastric neuroendocrine tumors after endoscopic diagnosis and treatment

“…[ 7 , 8 ] Type I and II GNETs are often female preponderant, multiple, small size (<10∼20 mm), proximal located, well-differentiated [World Health Organization (WHO) grade (G) 1 and 2], limited to mucosa and submucosa layers, and associated with hypergastrinemia. [ 7 , 9 , 10 ] Type I, which is the major subtype of GNETs, may be associated with chronic atrophic gastritis/autoimmune gastritis with pernicious anemia, Helicobacter pylori infection, and higher intragastric pH level, whereas type II may be associated with multiple endocrine neoplasia (MEN)-I, Zollinger–Ellison syndrome (ZES) and intragastric hyperacidity. [ 7 – 10 ] The prognosis of type I and II are favorable with tumor related death rate less than 10%.…”

Pedunculated gastric neuroendocrine tumor: a case report

“…In the current case, the patient had hoped for endoscopic treatment of his gastric lesion. ESD is reportedly more feasible than endoscopic mucosal resection for removal of type I gastric carcinoid [7]. Complete histologic resection was performed by ESD in the current case, and no complications such as bleeding or gastric perforation occurred during or after endoscopic treatment.…”

“…Gastric NETs are classified into 3 subtypes: Type I lesions arising in patients with chronic atrophic gastritis, including autoimmune gastritis and H. pylori-associated atrophic gastritis; Type II lesions associated with gastrin-producing neoplasms in patients with multiple endocrine neoplasia or Zollinger-Ellison syndrome; and Type III gastric lesions, which are sporadic carcinoids without specific background factors [7]. In this case, the disease was negative for both anti-parietal cell antibody and anti-intrinsic factor.…”

“…The aim in treating gastric NET should always be to maintain good quality of life for as long as possible [4]. Carcinoids generally have an excellent prognosis, especially type I gastric carcinoid tumors, which have low malignant potential and low frequency of metastasis [4,7,8]. Patients managed by lesion resection and endoscopic follow-up have a 100 % survival rate when the lesions are confined to the submucosa and there are no metastases during observation [8].…”

Gastric carcinoid tumor after laparoscopic gastric banding: Case report of a patient with weight regain

“…Diagnosis is obtained by endoscopic biopsy and immunohistochemical study for chromogranine A and synaptophysin. For better evaluation and staging ultrasound and CT-scan are recommended [ [6] , [7] , [8] ]. Usually the tumor treatment is done by resection with the exemption of some cases of Type 1 tumor in the elderly population where it may be controlled.…”