Gastric Carcinoid and Obesity: Association or Coincidence? Report of Two Cases and Literature Review

Abstract

Bariatric surgery is a prevalent procedure due to the high incidence of obesity and comorbidities. Upper gastrointestinal endoscopy is one of the procedures used to evaluate the patient before surgery. However, its role is questionable. The incidental findings during endoscopy are variable including inflammatory diseases, and ulcers, and epithelial and stromal tumors. Herein a report of two obese sisters with incidental gastric carcinoids was diagnosed in prebariatric surgery endoscopy. Case Summary. 35- and 41-year-old female patients presented with obesity and BMI of 102 and 46 kg/m2, respectively. Both patients underwent upper gastrointestinal endoscopy as part of presurgical evaluation. Multiple polyps were indentified in both patients, and biopsy was taken. Histological examination revealed tumors that were formed by nests of epithelial cells. The cells have eosinophilic cytoplasm and monomorphic nuclei, typical morphology of neuroendocrine tumors. Conclusions. (1) Upper gastrointestinal endoscopy is an important procedure for prebariatric surgery evaluation. (2) Gastric carcinoid is a rare tumor with higher incidence among obese patients.

Visceral Obesity and Metabolic Syndrome Are Associated with Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors

“…A meta-analysis published in 2016 [ 23 ] describes two case-control studies linking BMI and pNETs [ 24 , 25 ] with a pool risk of 1.37 (95% CI 0.25 to 7.69, p < 0.001). The prevalence of incidental gastric NETs in obesity surgery candidates was found to be high [ 26 ] and the occurrence of a pNET co-secreting GLP-1 and glucagon in a patient previously submitted for gastric bypass surgery was also reported [ 27 ]. Although our data does not support an association between overweight or obesity with WD GEP-NETs, visceral obesity as assessed by the WC criteria for MetS was associated with an increased risk for WD GEP-NETs.…”

Simple, Safe, and Cost-Effective Technique for Resected Stomach Extraction in Laparoscopic Sleeve Gastrectomy

“…In order to facilitate the extraction of a specimen of this size using retrieval bags, Mahmood and Silbergleit suggested to morcellate the specimen [ 6 ]. In the literature, the rate of incidental malignancies observed during pathological assessment of the specimen after LSG was reported as 0.2% [ 11 , 12 ]. The method suggested by Mahmood and Silbergleit may complicate pathological examination.…”

Finding carcinoid tumor before bariatric surgery. Is preoperative endoscopy necessary? Case report

“…Gastric carcinoid tumors have been increasingly reported in endoscopies performed before bariatric surgery in recent years [6,7]. In this report, we present a case of carcinoid tumor detected by preoperative upper GI endoscopy in a morbidly obese patient prepared for bariatric surgery.…”