Gastrik karsinoid tümörler

Amaç: Üst gastrointestinal sistem endoskopisinin yaygın olarak kullanılması ile son yıllarda sıklığında artış saptanan 5 gastrik karsinoid olgusunu sunmayı amaçladık. Olgu sunumu: Pernisiyöz anemi tanısı ile izlenen 4 olgu ve dispeptik yakınmaları olan 5 olgunun kontrol üst gastrointestinal endoskopisinde midede küçük multipl polipoid lezyonlar saptanması üzerine yapılan endoskopik polipektomi ve biyopsi sonuçlarında gastrik karsinoid tümör saptandı. Hastalara total mide rezeksiyonu ve D-ll lenf nodu diseksiyonu uygulandı. Histopatolojik olarak gastrik atrofi ve intestinal metaplazi saptandı. Sonuç: Histopatolojik olarak saptanan gerek gastrik atrofi ve intestinal metaplazi gerekse sınırlı rezeksiyonun dezavantajları nedeni ile gastrik karsinoid tümörler için seçilecek tedavinin total mide rezeksiyonu olduğu kanısındayız.

Anahtar Kelimeler:

Mide neoplazmları, Anemi, pernisiyöz, Atrofi, Mide

Gastric carcinoid tumors

With the widespread use of gastroscopy and awareness of its association between pernicious anemia, there is an apparent increase in the incidence of gastric carcinoid tumors. This report concerns the clinical and histopathologic findings of five patients with pernicious anemia, who developed gastric carcinoid tumors. Case report: Five patients with pernicious anemia, who underwent upper gastrointestinal endoscopy for dyspeptic complaints were found to have multiple polypoid lesions located in the corpus and fundus of the stomach. Endoscopie biopsy revealed the diagnosis of multifocal gastric carcinoids. All patients underwent total gastrectomy with D-ll lymphadenectomy. Histopathologic examination of the gastrectomy specimen showed extensive intestinal metaplasia and^nronic atrophie gastritis in all cases. Conclusion: Because of the associated atrophie gastritis with intestinal metaplasia and the difficulties in the follow up of the patients undergoing lesser alternatives, we recommend total gastrectomy for the patients with gastric carcinoid tumors.

Keywords:

Stomach Neoplasms, Anemia, Pernicious, Atrophy, Stomach,

PDF

___

1. Gilligan CJ, Lawton GP, Tang LH, West AB, Modlin IM. Gastric carcinoid tumours: The biology and therapy of an enigmatic and controversial lesion. Am J Gastroenterol 1995;90:338-52.
2. Modlin IM, Sandor A, Tang, LH, Kidd M, Zelterman D. 40 year analysis of gastric carcinoids. Am J Gastroenterol 1997;92:633-8.
3. Bektas H, Langer F, Piso P, Werner U, Musholt TJ, Lehner F, et al. Gastric carcinoid tumours. Chirurg 2002;73:331-5.
4. Yu JY, Wang LP, Meng YH, Hu M, Wang JL, Bordi C. Classification of gastric neuroendocrine tumours and its clinicopathologic significance. World J Gastroenterol 1998;4:158-61.
5. Dickman R, Shaklai M, Lapidot M, Okon E, Zandbank J, Fraser GM, et al. Pernicious anemia, gastric carcinoid, and autoimmune thrombocytopenia in a young women. Clin Gastroenterol 2000;30:299-302.
6. Schindl M, Kaserer K, Niederle B. Treatment of gastric neuroendocrine tumors; the necessity of a type adapted treatment. Arch Surg 2001;136:49-54.
7. Hirschowitz BI, Griffith J, Pelegrin D, Cummings OW. Rapid regression of enterochromaffin like cell gastric carcinoids in pernicious anemia after antrectomy. Gastroenterol 1992;102:1409-18.
8. Wangberg B. Are enterochromaffin like cell tumours reversible? An experimental study on gastric carcinoid induced in mastomys by histamine–2 receptor blockade. Regul Pept 1995;7;56:19-33.
9. Kitago M, Inada T, Igarashi S, Mizutani S, Ogata Y, Kubota T. Multiple gastric carcinoid tumors with type A gastritis concomitant gastric cancer: A case report. Oncol Rep 2001;8:343-6.
10. Modlin IM, Gilligan CJ, Lawton GP, Tang LH, West AB, Darr U. Gastric carcinoids. The Yale experience. Arch Surg 1995;130:250-6.