Massironi S, Sciola V, Spampatti MP, Peracchi M, Conte D. Gastric carcinoids: Between underestimation and overtreatment. World J Gastroenterol 2009; 15(18): 2177-2183
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Sara Massironi, Gastroenterology Unit II, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122 Milano, Italy. firstname.lastname@example.org
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World J Gastroenterol. May 14, 2009; 15(18): 2177-2183 Published online May 14, 2009. doi: 10.3748/wjg.15.2177
Gastric carcinoids: Between underestimation and overtreatment
Sara Massironi, Valentina Sciola, Matilde Pia Spampatti, Maddalena Peracchi, Dario Conte
Sara Massironi, Valentina Sciola, Matilde Pia Spampatti, Maddalena Peracchi, Dario Conte, Gastroenterology Unit II, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, and Postgraduate School of Gastroenterology, University of Milan, 20122 Milan, Italy
Author contributions: The Editorial was planned by Conte D who also corrected the final version; Massironi S developed the initial plan and wrote the first draft of the manuscript; Sciola V and Spampatti MP performed the literature search; Peracchi M and Massironi S edited subsequent versions of the manuscript.
Correspondence to: Sara Massironi, Gastroenterology Unit II, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122 Milano, Italy. email@example.com
Received: March 11, 2009 Revised: April 3, 2009 Accepted: April 10, 2009 Published online: May 14, 2009
Gastric carcinoids (GCs), which originate from gastric enterochromaffin-like (ECL) mucosal cells and account for 2.4% of all carcinoids, are found increasingly in the course of upper gastrointestinal tract endoscopy. Current nosography includes those occurring in chronic conditions with hypergastrinemia, as the type 1 associated with chronic atrophic gastritis, and the type 2 associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type 3, which is unrelated to hypergastrinemia and is frequently malignant, with distant metastases. The optimal clinical approach to GCs remains to be elucidated, depending upon type, size and number of carcinoids. While there is agreement concerning the treatment of type 3 carcinoids, for types 1 and 2, current possibilities include simple surveillance, endoscopic polypectomy, surgical excision, associated or not with surgical antrectomy, or total gastrectomy. Moreover, the recent introduction of somatostatin analogues represents a therapeutic option of possibly outstanding relevance.