Which is the correlation between carcinoid tumor and Laparoscopic Sleeve Gastrectomy? A case series and literature review

Sista, Federico; Abruzzese, Valentina; Carandina, Sergio; Salvatorelli, Andrea; Furia, M.; Cipolloni, Gianluca; Vicentini, Vincenzo; Guadagni, Stefano; Clementi, Marco

doi:10.1016/j.amsu.2018.09.010

Cited by 7 publications

(6 citation statements)

References 20 publications

(28 reference statements)

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“…Finally, 17 patients reported cancer arising in the esophagus or the stomach after SG were found in 15 articles. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] There were 4 esophageal cancers,4 gastroesophageal cancers and 9 gastric cancers. The characteristics of patients are summarized in Tables 1 and 2.…”

Section: Resultsmentioning

confidence: 99%

Esophagogastric Cancer After Sleeve Gastrectomy: A Systematic Review of Case Reports

Chen¹,

Wang²,

Zhu³

et al. 2021

CMAR

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Introduction: Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure. It has been shown that bariatric surgery reduces cancer risk. However, the risk of esophagogastric cancer after SG has not been defined yet and the development of cancer in the esophagus and stomach remains a matter of concern. Methods: Web of Science, PubMed and Embase databases were searched. Articles that described the diagnosis and management of esophageal or gastric cancer after SG were considered. Results: Seventeen esophagogastric cancer patients after SG were included. The age of the patients ranged from 21 to 64 years. Tumors were diagnosed after an interval of 33.9 ±22.8 months from SG (range 4 months-96 months). There were 4 esophageal cancers,4 gastroesophageal cancers and 9 gastric cancers; adenocarcinoma was the most frequent tumor histology (88.2%). The most commonly reported symptoms were food intolerance/dyspepsia (50.0%), vomiting/nausea/regurgitation (35.7%). Upper gastrointestinal endoscopy (UGIE) with biopsy was used for diagnosis in most of the patients. Surgery was performed in 10 patients (58.8%), while 4 patients were treated by endoscopic procedures (23.5%). The mean follow-up length was 12.2 months (range 3 months-36 months) and the overall disease-free survival rate was 88.9%. Conclusion:The development of esophagogastric cancer after SG is still not well defined but it may occur at any time. Preoperative and follow-up UGIE are essential in order to allow for prevention, early diagnosis. Further epidemiologic studies are needed to investigate the post-SG-related risk of esophagogastric cancer development.

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Section: Resultsmentioning

confidence: 99%

Esophagogastric Cancer After Sleeve Gastrectomy: A Systematic Review of Case Reports

Chen¹,

Wang²,

Zhu³

et al. 2021

CMAR

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“…12 Morbid obesity and gastric sleeve surgery are reportedly associated with incidental gastric neuro endocrine tumors during laparoscopic evaluation. 13 The pathophysiology of gastric neuro endocrine tumors after bariatric surgery has not been fully elucidated. However, it was hypothesized that hormonal changes induced by morbid obesity or after gastric sleeve surgery causes alterations in the gastrin level leading to physiological changes in gut-brain axis.…”

Section: Discussionmentioning

confidence: 99%

A case of tumor-induced osteomalacia masked by acute kidney injury

Kanduri

Kovvuru

Wickman

2022

Journal of Onco-Nephrology

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Introduction: Hypophosphatemia in patients with tumor-induced osteomalacia (TIO) is due to abnormal excess production of fibroblast growth factor 23 (FGF-23) causing urinary phosphate wasting. However, in patients with coexisting acute kidney injury (AKI), hypophosphatemia may not be apparent as AKI reduces filtration and excretion of phosphate. Case report: We describe a case of 36-year-old woman who presented with right-sided abdominal pain. Initial laboratory testing revealed non oliguric AKI with creatinine (Cr) of 2.0 mg/dL (baseline 1.2 mg/dL), low phosphate (1.8 mg/dL), and normal parathyroid (PTH) levels. Hypophosphatemia in the setting of AKI and normal PTH raised suspicion for renal phosphate wasting disorder independent of PTH, triggering an order for FGF-23 level. Further into hospital stay, the AKI worsened (Cr rose to 7.2 mg/dL) and phosphate levels increased to 6.7 mg/dL casting doubt on the initial suspicion. However, FGF-23 level resulted at 12,715 RU/mL, strongly suggesting TIO. Random liver biopsy was obtained as part of TIO work up due to liver ultrasound findings of hepatomegaly, diffuse parenchymal heterogenicity mimicking steatosis and potential ill-defined mass. Liver specimen showed tumor cells positive for CD56 and Ki-67, indicating high-grade metastatic neuro endocrine tumor which was the likely source of FGF-23. Patient rapidly deteriorated and opted for comfort measures. Conclusion: TIO typically manifests with overt hypophosphatemia. This case highlights the fact that decreased glomerular filtration rate may mask the degree of urinary phosphate wasting resulting in normal to high serum phosphate level. This warrants high index of suspicion to diagnose an underlying phosphate wasting disorder in the setting of normal to high serum phosphate levels and reduced kidney function.

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“…Bariatric surgery has become the preferred treatment and laparoscopic sleeve gastrectomy (LSG) is one of the most effective surgical procedures to get it under control [3]. Histopathological samples taken after surgery are usually normal; however, in rare cases, pathological findings will lead us to change our entire treatment plan [1,4]. LSG is the only surgical procedure that provides samples for histopathological examination [2,3].…”

Section: Introductionmentioning

confidence: 99%

Histopathological findings in laparoscopic sleeve gastrectomy specimens: Are pathological examinations necessary?

Sözen¹,

Gencturk²,

Emir³

et al. 2022

World J. Adv. Res. Rev.

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Objective: The objective of this study is to determine the prevalence of gastric histopathological findings in patients who underwent laparoscopic sleeve gastrectomy (LSG) in our hospital and to add more data to the published literature on the characteristics of the resected LSG samples. Material and Methods: The pathology reports of the patients were retrospectively analyzed to identify all patients with consecutive morbidly obesity who underwent LSG from January 2015 to December 2019. All patients underwent gastroscopy in the preoperative period. Results: The study analyzed 800 patient reports. No specific pathological finding was observed in 230/800 (28.75%) of the patients, which was reported as normal. Specific pathological findings were present in 570 (71.25%) patients. Cases of chronic inactive gastritis (400 patients [50%] ), chronic active gastritis (134 patients [16.7%] ), intestinal metaplasia (2 patients [0.2%] ), low-grade dysplasia (1 patient [0.12%] ), stromal tumor (7 patients [0.87%] ), Neuroendocrine (NE) cell hyperplasia (7 patients [0.87%] ), fundic gland polyps (3 patients [0.37%] ), granulomatous gastritis (1 patient [0.12%] ), acute gastritis (1 patient [0.12%] ) and ectopic pancreas (1 patient [0.12%] ) were recorded. Conclusion: Surgeons should be aware of the high unexpected histopathological prevalence in bariatric patients. Although our study did not find any malignant pathological result, we believe that routine postoperative pathological examination and preoperative endoscopy are necessary for medicolegal reasons.

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Which is the correlation between carcinoid tumor and Laparoscopic Sleeve Gastrectomy? A case series and literature review

Cited by 7 publications

References 20 publications

Esophagogastric Cancer After Sleeve Gastrectomy: A Systematic Review of Case Reports

Esophagogastric Cancer After Sleeve Gastrectomy: A Systematic Review of Case Reports

A case of tumor-induced osteomalacia masked by acute kidney injury

Histopathological findings in laparoscopic sleeve gastrectomy specimens: Are pathological examinations necessary?

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