gastric carcinoid
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Classification
- type 1 lesions (65%)
- occur in the setting of chronic atrophic gastritis
- generally identified as incidental finding on endoscopy for non-specific gastrointestinal signs & symptoms
- gastrin from G-cells in the gastric antrum stimulate growth of type 1 gastric carcinoid
- type 2 gastric carcinoid tumors occur in the context of ZE syndrome, MEN1, neurofibromatosis-1
- type 3 gastric carcinoid tumors (20%)
- unfavorable prognosis
Epidemiology
- < 5% of carcinoid tumors
Laboratory
- serum gastrin
- in type 1, serum gastrin may be as high as 550 pg/mL[1]
- serum gastrin elevated in type 2
- serum gastrin is normal in type 3
Diagnostic procedures
- upper gastrointestinal endoscopy every 6-12 months for at least 3 years for small (<= 2cm) type 1 lesion[1]
Complications
- metastasis
- rare in type 1
- more common in type 3
Management
- endoscopic resection of small (< 1 cm) type 1 gastric carcinoid tumors with < 5 lesions is curative & further treatment or surveillance is unnecessary[1]
- for type 1 gastric carcinoid tumors <= 2 cm
- upper gastrointestinal endoscopy every 6-12 months for at least 3 years
- 5 year survival > 95%
- type 1 gastric carcinoid tumors > 5 cm
- type 2 gastric carcinoid tumors
- octreotide is used for control of flushing & diarrhea that occur in the context of ZE syndrome or MEN1 associated with type 2 tumors[1]
- type 3 gastric carcinoid tumors
- total gastrectomy
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 19. American College of Physicians, Philadelphia 2012, 2015, 2021
- ↑ Hwang JH, Rulyak SD, Kimmey MB et al American Gastroenterological Association Institute technical review on the management of gastric subepithelial masses. Gastroenterology. 2006 Jun;130(7):2217-28. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16762644
- ↑ Crosby DA, Donohoe CL, Fitzgerald L et al Gastric neuroendocrine tumours. Dig Surg. 2012;29(4):331-48 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23075625 Free full text