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Gastric Carcinoids: Classification and Diagnosis

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Management of Pancreatic Neuroendocrine Tumors

Abstract

Gastric carcinoids are a subset of neuroendocrine tumors with a distinct pathogenesis and classification. Overall incidence has been increasing with the growing availability and use of endoscopy. There are three major types of gastric carcinoid. Type I and type II carcinoids are driven by the presence of hypergastrinemia and generally progress with a benign disease course. Type I is associated with type A chronic atrophic gastritis and type II is associated with Zollinger-Ellison syndrome in patients with multiple endocrine neoplasia type 1. In contrast, type III gastric carcinoids arise sporadically, have a much higher incidence of metastasis, and carry a graver prognosis. As symptoms are frequently nonspecific or minimal, diagnosis is often made incidentally on routine or surveillance endoscopy. Carcinoid syndrome is very rare with these tumors and presents in an atypical manner. The mainstay of treatment is endoscopic removal of small lesions with no evidence of invasion. Aggressive surgical therapy is reserved for larger invasive tumors or patients with type III tumors.

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Abbreviations

5-HIAA:

5-hydroxylindoleacetic acid

CAG:

Chronic atrophic gastritis

CT:

Computed tomography

ECL:

Enterochromaffin-like

EMR:

Endoscopic mucosal resection

EUS:

Endoscopic ultrasound

GC:

Gastric carcinoid

GEP-NET:

Gastroenteropancreatic-neuroendocrine tumor

MEN1:

Multiple endocrine neoplasia type 1

SRS:

Somatostatin receptor scintigraphy

WHO:

World Health Organization

ZES:

Zollinger-Ellison syndrome

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Author information

Authors and Affiliations

  1. Department of Medicine, UCLA, 57 Westwood Plaza, Suite B7-111, Mailcode 742430, Los Angeles, CA, 90095, USA

    Kali Zhou M.D.

  2. Department of Medicine, Division of Digestive Diseases, UCLA, 100 UCLA Medical Plaza, Suite 303, Los Angeles, CA, 90095, USA

    Wendy Ho M.D., M.P.H.

Authors
  1. Kali Zhou M.D.
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  2. Wendy Ho M.D., M.P.H.
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Corresponding author

Correspondence to Wendy Ho M.D., M.P.H. .

Editor information

Editors and Affiliations

  1. VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA VA Greater Los Angeles Healthcare System, Los Angeles, California, USA

    Joseph R. Pisegna

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Zhou, K., Ho, W. (2015). Gastric Carcinoids: Classification and Diagnosis. In: Pisegna, J. (eds) Management of Pancreatic Neuroendocrine Tumors. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1798-3_6

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  • DOI: https://doi.org/10.1007/978-1-4939-1798-3_6

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1797-6

  • Online ISBN: 978-1-4939-1798-3

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