Sauer J, Hinze R, Dommisch K
Chirurgische Klinik, HELIOS Kliniken Schwerin, Schwerin.
Dtsch Med Wochenschr. 2007 Oct;132(40):2077-80. doi: 10.1055/s-2007-985644.
A 38-year-old woman was admitted for the diagnosis of joint pains. She had no gastrointestinal symptoms.
Barium contrast examination revealed a rigid gastric wall. Gastroscopy showed multifocal carcinoid (neuroendocrine) tumors, up to 3 mm in diameter, and a 2 cm tumor which had apparently not metastasised (as demonstrated by sonography and computed tomography), but had broken into the muscular layer.
A partial gastrectomy and lymphadenectomies were performed. Histology showed a mixed exocrine-endocrine carcinoma with submucosal infiltration and lymph node metastases. The postoperative course was without complications.
Neuroendocrine tumors are rare diseases of the stomach for which therapeutic options are surgical resection or endoscopic removal. Tumors up to 1 cm diameter and concomitant type A gastritis, multiple endocrine neoplasms with infiltration or Zollinger-Ellison syndrome are removed endoscopically. Bigger tumors or tumors that have infiltrated the muscular layer are managed by partial gastrectomy In our opinion radical surgery is required in all carcinoids larger than 1 cm and other neuroendocrine tumors.
一名38岁女性因关节疼痛入院诊断。她无胃肠道症状。
钡剂造影检查显示胃壁僵硬。胃镜检查发现多灶性类癌（神经内分泌）肿瘤，直径达3毫米，还有一个2厘米的肿瘤，超声检查和计算机断层扫描显示该肿瘤显然未发生转移，但已侵犯肌层。
行胃部分切除术及淋巴结清扫术。组织学检查显示为混合性外分泌-内分泌癌，伴有黏膜下浸润及淋巴结转移。术后病程无并发症。
神经内分泌肿瘤是胃部罕见疾病，其治疗选择为手术切除或内镜下切除。直径达1厘米且伴有A型胃炎、浸润性多发性内分泌肿瘤或卓-艾综合征的肿瘤可通过内镜切除。较大的肿瘤或已侵犯肌层的肿瘤则行胃部分切除术。我们认为，所有直径大于1厘米的类癌及其他神经内分泌肿瘤均需行根治性手术。
