Gastric carcinoids: between underestimation and overtreatment

Gastric carcinoids (GCs), which originate from gastric enterochromaffin-like (ECL) mucosal cells and account for 2.4% of all carcinoids, are found increasingly in the course of upper gastrointestinal tract endoscopy. Current nosography includes those occurring in chronic conditions with hypergastrin...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2009-05, Vol.15 (18), p.2177-2183
Main Authors: Massironi, Sara, Sciola, Valentina, Spampatti, Matilde-Pia, Peracchi, Maddalena, Conte, Dario
Format: Article
Language:English
Subjects:
Carcinoid Tumor - diagnosis
Carcinoid Tumor - epidemiology
Carcinoid Tumor - pathology
Carcinoid Tumor - therapy
Female
Humans
Male
Somatostatin - analogs & derivatives
Somatostatin - therapeutic use
Stomach Neoplasms - diagnosis
Stomach Neoplasms - epidemiology
Stomach Neoplasms - pathology
Stomach Neoplasms - therapy
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Description
Summary:Gastric carcinoids (GCs), which originate from gastric enterochromaffin-like (ECL) mucosal cells and account for 2.4% of all carcinoids, are found increasingly in the course of upper gastrointestinal tract endoscopy. Current nosography includes those occurring in chronic conditions with hypergastrinemia, as the type 1 associated with chronic atrophic gastritis, and the type 2 associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type 3, which is unrelated to hypergastrinemia and is frequently malignant, with distant metastases. The optimal clinical approach to GCs remains to be elucidated, depending upon type, size and number of carcinoids. While there is agreement concerning the treatment of type 3 carcinoids, for types 1 and 2, current possibilities include simple surveillance, endoscopic polypectomy, surgical excision, associated or not with surgical antrectomy, or total gastrectomy. Moreover, the recent introduction of somatostatin analogues represents a therapeutic option of possibly outstanding relevance.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.15.2177