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Neuroendocrine tumors of the stomach (gastric carcinoids) are on the rise: small tumors, small problems?
- Source :
- Endoscopy. 42:664-671
- Publication Year :
- 2010
- Publisher :
- Georg Thieme Verlag KG, 2010.
-
Abstract
- Well differentiated neuroendocrine tumors (NETs) of the stomach (gastric carcinoid tumors) are observed more often, with a tenfold increase in the US in the last 30 - 35 years, and the prognosis has improved greatly in that time. Nowadays most carcinoids of the stomach are diagnosed at an early stage. Four types of gastric NETs have been proposed and recognition of the type is important for defining the diagnostic approach and treatment. Often gastric NETs (especially type 1) are found incidentally during a gastroscopy performed for other reasons; most of these NETs are smaller than 20 mm in size. Conservative management and endoscopic surveillance is adequate for well differentiated, multifocal gastric carcinoids (type 1 or type 2 gastric NETs) that are less than 10 - 20 mm in diameter, unless they show angioinvasion, infiltrate the muscular wall, or have a proliferation rate above 2 %. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. It is essential to distinguish between multifocal (types 1 and 2) and unifocal type 3 or type 4 gastric NETs, since surgery is indicated for type 3 gastric NETs larger than 10 mm in diameter and for poorly differentiated (localized) neuroendocrine gastric carcinomas (type 4 gastric NET). For optimal management, the type, biology, and stage of the tumor as well as the individual situation of the patient must be considered. Most patients with well differentiated gastric NETs can be treated conservatively and be followed up with endoscopic surveillance.
- Subjects :
- Endoscopic ultrasound
medicine.medical_specialty
Angioinvasion
Tumor size
medicine.diagnostic_test
business.industry
Stomach
digestive, oral, and skin physiology
Gastroenterology
Neuroendocrine tumors
medicine.disease
digestive system diseases
Optimal management
medicine.anatomical_structure
Internal medicine
medicine
Carcinoma
business
Small tumors
Subjects
Details
- ISSN :
- 14388812 and 0013726X
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Endoscopy
- Accession number :
- edsair.doi...........198d183408c6cd8316e32483d2b53f42