Unusual Presentation of a Neuroendocrine Tumor of Stomach as an Ulcer (original) (raw)
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Type 1 Gastric Neuroendocrine Tumor Found on Endoscopic Polypectomy
Gastric neuroendocrine tumors (GNET) are rare gastric neoplasms accounting for <1% of all gastric neoplasms. The World Health Organization (WHO) categorized these neoplasms as types 1-3 to help predict malignant potential and long-term survival and guide management. Improved outcomes have been shown with endoscopic resections, but further studies are needed to confirm the best approach. We present a case of a 56-year-old woman who demonstrated the classic features of type one GNET with mucosal and submucosal involvement in the setting of primary atrophic gastritis, secondary hypergastrinemia, and underlying pernicious anemia. In general, standardizing treatment has been difficult due to a variable presentation.
A Clinical Perspective on Gastric Neuroendocrine Neoplasia
Current Gastroenterology Reports, 2010
The incidence of gastric neuroendocrine tumors (NETs) has increased exponentially based on widespread use of endoscopy and a greater pathological awareness of the condition. A key concern is the potential association with hypergastrinemia induced by proton pump inhibitor administration. Previous confusion regarding diagnosis and therapy has been diminished by a series of international consensus statements defining the biology and management strategies for the disease. Overall, gastric NETs are categorized as welldifferentiated or poorly differentiated neoplasms. Welldifferentiated gastric NETs are enterochromaffin-like (ECL) cell tumors subclassified into three types based on their relationship to gastrin, a key regulator of ECL cell neoplastic transformation. The treatment of type 1 and type 2 tumors depends on the size and invasiveness of the tumor, whereas type 3 tumors and poorly differentiated neuroendocrine carcinomas warrant aggressive surgical resection. The disease-specific 5-year survival ranges from about 95% in type 1 gastric carcinoids to about 25% in poorly differentiated gastric NECs. Elucidation of the precise biology of a gastric NET is critical to diagnosis and delineation of a typespecific management strategy.
Turkish Journal of Surgery, 2017
Amaç: Neuroendocrine tumors (NETs) arise from neuroendocrine cells in any parts of the body, of which about twothirds are located in the gastrointestinal tract and pancreas. Though gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are known as rare neoplasms,the prevalance has recently increased due to advanced diagnostic methods and increased awareness of the disorder. In the present study,we aimed to review the patients who had been treated and followed-up for GEP-NET at our clinic in terms of clinical pictures,pathological findings,and prognosis. Materials and Methods: Data from a total of 42 patients with the diagnosis of GEP-NET who had been treated and followed-up at our Training and Research Hospital from (August 2011 to December 2015) were retrospectively evaluated. Results: A total of 42 patients aged 17-81 years (mean age 46.9 years) were enrolled into the study. The most common symptom was abdominal pain seen in 31 (73.8%) patients.GEP-NETs were detected in stomach (n=5, 35.7%), appendix (n=11,26.2%), rectum (n=6, 14.3%), pancreas (n=4, 9.5%), ileum and colon (n=2, 4.8%), duodenum and jejunum (n=1,2.4%). A local excision was performed in 7 (16.7%) patients. Nine (21.4%) patients underwent gastric wedge resections, either as a laparoscopic procedure (n=3) or as an open surgery (n=6). Total gastrectomy and laparoscopic subtotal gastrectomy were used in three (7.1%) patients and 2 patients (4.8%), respectively. After surgical procedures, the patients were followed-up for a mean period of 36 months (15-57 months) and 1-year and 3-year survival rates were determined as 100% and 97.6%,respectively. Conclusion: Management of GEP-NETs need an accumulation of knowledge and experience to make a standardized approach. Therefore, we believe that collecting regular national data from these cases in every country will contribute to understanding of the details of this entity in all over the world.
GE - Portuguese Journal of Gastroenterology, 2021
Neuroendocrine tumors (NETs) are rare tumors derived from the neuroendocrine cell system, and more commonly found in the gastrointestinal (GI) tract. Over the last decades, the incidence of GI-NETs has been steadily increasing, partly due to the expanding indications for endoscopy. Most patients with NETs are asymptomatic, and their NETs are noticed during screening examinations; thus, endoscopists are on the frontline of the diagnosis of GI-NETs. Since GI-NETs are less frequent than other malignancies, the natural history, diagnosis, and management of these tumors may not be fully understood. In this review, we aim to update the endoscopist on key clinical features and management of patients with gastric, duodenal, and rectal NETs.
Neuroendocrine gastric carcinoma in a young patient
Vojnosanitetski pregled, 2010
Background. Neuroendocrine tumors cover a spectrum of neoplasms showing wide variations in their clinicopathological and pathogenetic features, as well as prognosis. They may develop throughout the whole gastrointestinal tract. Case report. We described a case of gastric neuroendocrine carcinoma in a 29-year-old male. The patient presented with chronic continuous abdominal pain and weight loss over a 6month period. Preoperative diagnosis, operative findings, histology and immunohistochemistry of the tumor confirmed the diagnosis of the rare neuroendocrine gastric carcinoma, stage T2N1. Conclusion. Case reports of this rare tumor are important, because of the paucity of studies noted in the gastrointestinal literature as a result of poor identification prior to the advent of modern immunohistochemistry. Significance of accurately diagnosing gastrointestinal neuroendocrine tumors is crucial for an appropriate treatment.
Gastric neuroendocrine tumors Chapter 1 Overview on Gastric Cancer
2017
Gastric Neuroendocrine Tumors (NET)s are classified on the basis of criteria that are common to all gastrointestinal and pancreatic neuroendocrine neoplasms. Most neuroendocrine neoplasms of the stomach are NETs –well differentiated, nonfunctioning enterochromaffin–like(ECL) cell carcinoids (ECL cell NETs)-arise predominantly in the corpus-fundus region [1]. Three distinct types are recognized :
An atypical type I gastric neuroendocrine tumor
Romanian Journal of Internal Medicine
Gastric neuroendocrine tumors(GI-NETs) are rare lesions, usually discovered incidentally during endoscopy. Based on their pathology, there are 4 types of GI-NETs. Type I are multiple small polypoid lesions with central ulceration located in the gastric body or the fundus, associated with atrophic gastritis usually noninvasive and very rarely metastatic. We report on a rare case of a gastric NET arising from the muscularis propria layer of the pyloric ring.We present the case of a 65-year old woman with a history of alcoholic cirrhosis, investigated for melena. Upper endoscopy revealed a 30 mm submucosal pedunculated polypoid lesion located on the pylorus protruding in the duodenum, with normal overlying mucosa, fundic gastric atrophy and multiple small polyps at this level, with no active bleeding. CT scan did not reveal any distant metastases. An ultrasound endoscopy was performed, and a round hypoechoic heterogeneous solitary mass, evolving from the pyloric muscle was described. C...
Neuroendocrine carcinoma of stomach causing gastric outlet obstruction: a diagnostic dilemma
International Surgery Journal
Gastric neuroendocrine tumour (GNET), also known as carcinoids, are a very rare cause of gastric outlet obstruction and arise from entero-chromaffin like cells of the mucosa. They account for 0.2/1000001 population and 8.7% of all Gastrointestinal carcinoids. They are four types based on the degree of differentiation, cell of origin and other pathologic features. Type 4 GNET are referred to as neuroendocrine carcinoma accounting for <1% of GNET. They are aggressive, poorly differentiated, locally invasive tumours with metastatic potential. Hence, they require an aggressive approach in terms of surgery and multimodality adjuvant treatment. Our patient is an elderly hypertensive who had complaints of projectile vomiting over ten days associated with weight loss over the last two years. A diagnosis of gastric outlet obstruction was made, and she underwent a contrast CT scan and endoscopy twice, both being suggestive of malignancy involving the antrum region however, the endoscopic b...
Gastric neuroendocrine neoplasias: manifestations and comparative outcomes
Endocrine-Related Cancer
Although gastric neuroendocrine neoplasias (gNEN) are an orphan disease, their incidence is rising. The heterogeneous clinical course powers the ongoing discussion of the most appropriate classification system and management. Prognostic relevance of proposed classifications was retrospectively analyzed in 142 patients from a single tertiary referral centre. Baseline, management and survival data were acquired for statistical analyses. The distribution according to the clinicopathological typification were: gNEN-1 (n=86/60.6%), gNEN-2 (n=7/4.9%) gNEN-3 (n= 24/16.9%) and gNEN-4 (n=25/17.6%); while hypergastrinemia-associated gNEN-1 and -2 were all low grade tumours (NET-G1/2), formerly termed sporadic gNEN-3 could be subdivided into gNEN-3 with grade 1 or 2 and gNEN-4 with grade 3 (NEC-G3). During follow-up 36 patients died (25%). The mean overall survival (OS) of all gNEN was 14.2 years. The OS differed statistically significant across all subgroups with either classification system....