Open AccessGastric carcinoids: Between underestimation and overtreatment
Author(s) -
Sara Massironi,
V. Sciola,
Matilde Pia Spampatti,
M. Peracchi,
Dario Conte
Publication year - 2009
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.15.2177
Subject(s) - medicine , atrophic gastritis , gastroenterology , zollinger ellison syndrome , somatostatin , multiple endocrine neoplasia , gastrectomy , gastrinoma , gastric polyp , enterochromaffin cell , endoscopy , intestinal metaplasia , cancer , stomach , gastritis , gastrin , biology , biochemistry , receptor , secretion , gene , serotonin
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.