Minute gastric carcinoid tumor with regional lymph node metastasis

Abstract

gastroscopy and improvements in immunohistological techniques.Rindi et al. [3][4][5] have characterized three clinicopathologic subtypes of gastric carcinoid tumors. Further, the behavior of any gastric carcinoid tumor depends on its size and depth [6,7].So far, a minute gastric carcinoid tumor has been regarded as a benign tumor, for which endoscopic excision is recommended. In this report, we describe a case of minute sporadic gastric carcinoid tumor associated with regional lymph node metastasis. We also present a review of the literature. Case reportA 50-year-old asymptomatic man was referred to our hospital for further evaluation of an elevated lesion on the anterior wall of the gastric body, detected by a series of upper gastrointestinal examinations. Routine hematologic study revealed no abnormality, and liver and kidney functions were normal. Levels of tumor markers, serum gastrin, and urinary 5-hydroxyindole acetic acid (5-HIAA) were all within normal ranges. Careful gastrointestinal examinations disclosed two lesions, a small elevated lesion with a central depression on the anterior wall of the gastric body, and a superficial depressed lesion in the greater curvature, near the elevated lesion (Fig. 1A,B). Computed tomography (CT) and ultrasonography (US) scans of the upper abdomen showed no metastasis. Biopsy specimens revealed that the depressed lesion was consistent with a poorly differentiated adenocarcinoma and the elevated lesion was a typical carcinoid tumor.Because of the low probability of lymph node metastasis, and to preserve the stomach function, segmental gastrectomy, together with perigastric lymph node dissection, was performed (The resected stomach is shown in Fig. 2A). Histologically, the depressed lesion However, the case we present suggests that attention should be paid to the possibility of metastasis at the time of treatment for a minute sporadic gastric carcinoid tumor. We therefore discuss the malignant potential of these tumors, mainly from the viewpoint of histopathological classification, to gain understanding so that the patients can be treated adequately.

A 15-year experience with gastric neuroendocrine tumors: Does type make a difference?

“…This type typically presents with larger tumors, mean size of 3.2 cm in this series, and higher grade, including G3, than other GNET types . Lymph node metastases are more common with Type 3 tumors with rates reported at greater than 50%, similar to those of the current series; this nodal spread has even been reported in sub‐centimeter tumors . In this study, 40% of Type 3 patients presented with Stage IV disease.…”

Concomitant gastric carcinoid and gastrointestinal stromal tumors: A case report

“…The third sporadic subtype (type Ⅲ) occurs without hypergastrinemia but takes an aggressive course, with 54%-66% metastasis [1] . As stated by Shinohara and colleagues, even a 0.5-cm carcinoid tumor can present with metastasis [8] . On account of neither atrophic gastric mucosa nor elevated seral gastrin level in our case, a small type Ⅲ carcinoid tumor was favored.…”

(Neuro-)Endokrine Tumoren des Magens sind auf dem Vormarsch: Gute Prognose bei frühem Nachweis

“…Bei allen diesen Tumoren gilt der Grundsatz, dass die Prognose des vorliegenden Tumors durch den exokrinen Anteil bestimmt wird [31]. Dies bedeutet, dass primär operiert werden soll und sich das therapeutische Vorgehen dabei ganz nach den Leitlinien zur Behandlung des gewöhnlichen Adenokarzinoms des Magens richtet.…”