Federmann M, Bansky G, Flury R
Medizinische Abteilung, Spital Schweizerische Pflegerinnenschule, Zürich.
Schweiz Rundsch Med Prax. 1994 Sep 27;83(39):1084-8.
We report about two patients with gastric neuroendocrine tumours (carcinoids) and chronic atrophic gastritis. A 68-year-old woman presented with nonspecific dyspeptic complaints. Gastroscopy revealed a single neuroendocrine tumour of the corpus. 33 months after endoscopic therapy she is free of detectable tumour. As cause of an upper gastrointestinal bleeding in a 75-year-old woman, a small ulcerated fundic neuroendocrine tumour was found together with other multiple tumours. Repeated endoscopic removals of these and further developing similar tumours were necessary during a follow-up of 25 months. Neuroendocrine tumours of the stomach are rare and are potentially malignant. According to their clinical context they can be divided into three subtypes: 1. tumours in chronic atrophic gastritis, 2. tumours in multiple endocrine neoplasia type I, 3. sporadic tumours, not associated with particular diseases. The first two types may be gastrin-promoted; they occur often multifocal only in the nonantral mucosa and seem to behave relatively benign. Metastasis limited to regional lymph nodes has not been described often. The very rare third type appears solitary in the whole stomach and seems to have a higher malignant potential with frequent distant metastasis to the liver. Therapy should be mainly guided by subtype and tumour size.
