Treatment of solitary gastric carcinoid tumor by endoscopic polypectomy in a patient with pernicious anemia

Abstract

Type I gastric carcinoid tumors result from hypergastrinemia in 1%-7% of patients with pernicious anemia. We diagnosed pernicious anemia in a 48-year-old female patient with complaint of fatigue for three months. She had no gastrointestinal symptoms. Endoscopic examination ot the upper gastrointestinal tract revealed atrophic gastritis and a polypoid lesion in the corpus of 3-4 mm in size. Endoscopic polypectomy was performed. Histopathological examination of the specimen revealed positive chromogranin A and synaptophysin stainings compatible with the diagnosis of a carcinoid tumor. Serum gastrin level was increased, urinary 5-hydroxyindoleacetic acid was within the normal range. There was no other symptom, sign, or laboratory finding of a carcinoid syndrome in the patient. No metastasis was found with indium-111 octreotide scan, computed tomographies of abdomen and thorax. Type I gastric carcinoid tumors are only rarely solitary and patients with tumors < 1 cm in size may benefit from endoscopic polypectomy.

Concomitant gastric carcinoid and gastrointestinal stromal tumors: A case report

“…Our case was asymptomatic and diagnosed as GIST with a very low risk of malignancy based on its small size and lack of mitosis and was positive for CD117 after IHC staining. Treatment modalities for non-metastatic small carcinoid tumors include endoscopic mucosal resection, minimally invasive laparoscopic wedge resection, and surgery [13,14] . To date, surgery is the mainstay and the only potentially curative therapy for carcinoid tumors.…”

En‐bloc resection of multiple type 1 gastric carcinoid tumors by endoscopic multi‐band mucosectomy

“…All our patients with type I carcinoids had confirmed atrophic gastritis, raised gastrin and they received complete en‐bloc resection of these lesions. Type I gastric carcinoid tumors occur in 1–7% of patients with pernicious anaemia, 14 we identified two patients with pernicious anemia and a further patient who had a type 1 autoimmune endocrinopathy (pernicious anemia, elevated gastrin and hypothyroidism).…”

“…Problems encountered in these reports were cases of heat‐induced tissue degeneration, incorrect specimen orientation or potential incomplete resection. This led to non‐assessable resection margins, which made evaluation of vascular invasion impossible, and follow‐up management uncertain 9,10,14 . Aspiration mucosectomy and strip biopsy methods have been shown to be effective in removing sub‐mucosal gastric tumors, however the techniques involve saline injection and either the use of a dual channel endoscope or repositioning of a snare around a suction cap for each resection 8 .…”

Carcinoid of the esophagus concomitant with adenocarcinoma of the esophagus: One case report and literature review

“…The treatment modality for carcinoid of the esophagus concomitant with adenocarcinoma of the esophagus is surgery [12][13][14][15][16][17][18] followed by chemotherapy including chemoembolization, radiotherapy and/or biotherapy. The initial treatment of functioning carcinoid of the esophagus concomitant with adenocarcinoma of the esophagus is to control the symptoms caused by excessive 5-hydroxytryptamine production.…”