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Report (EN)

2007 (EN)
Gastric carcinoids: Review a propos of two cases (EN)

V. Dimakopoulou, P. Economopoulos,, C. Christopoulos, E. Papavassiliou,

SUMMARY Gastric carcinoids are neoplasms originating from the endocrine cells of the gastric wall and represent less than 1% of all gastric tumours. Their frequency appears to be rising in parallel with the increasing use of upper gastrointestinal endoscopy and the development of techniques for specific immunohistochemical study of gastric biopsies. The pathophysiological classification of gastric carcinoids into three types is clinically useful. The majority (75-80%) belong to Type I, which is associated with chronic atrophic gastritis type A. They develop as a response to chronic hypergastrinaemia, causing sequentially hyperplasia, dysplasia and neoplasia of the ECL (enterochromaffin- like) cells. They follow a benign clinical course and only exceptionally metastasize. Type II carcinoids (5-13%) are also associated with hypergastrinaemia and develop in patients with the Zollinger-Ellison syndrome as part of multiple endocrine neoplasia type 1 (MEN1). They have a slightly higher malignant potential than type I carcinoids. Type III includes the sporadic gastric carcinoids (14-25%) which are invasive tumours with metastases often present at the time of diagnosis. They are not associated with hypergastrinaemia and require more aggressive surgical treatment than types I and II. We review the current management approaches and report two cases of gastric carcinoids, one demonstrating that classification of these tumours is not always straightforward and the other highlighting the importance of extensive endoscopic sampling in the setting of multiple gastric polypoid lesions. Key words: carcinoid, neuroendocrine tumour, gastric tumour, gastric polyp, atrophic gastritis, enterochromaffinlike cells, gastrin, gastrinoma (EN)




Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 17, No 3 (2004) (EN)

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