A Case of Multiple Gastric Carcinoids

Akio Machida¹⁾, Masahiko Murakami²⁾, Takashi Niiya²⁾, Ugen Ri¹⁾, Mitsuo Kusano²⁾, Nobuyuki Ohike³⁾ and Toshio Morohoshi³⁾

Department of Surgery, Shiroyama Hospital¹⁾, Second Department of Surgery²⁾ and
First Department of Pathology³⁾, Showa University

We observed a case of multiple carcinoids of the stomach with hypergastrinemia and type-A gastritis, A 49-year-old woman was found to have tiny elevated lesions on the body of the stomach, By gastroduodenal endoscopy the tiny elevated lesions were diagnosed by histology as carcinoid lesions. She had no symptoms or signs of typical carcinoid disease. In the laboratory examination, hypergastrinemia of 2670 pg/ml was found. We performed an endoscopic resection of the lesions using the stip biopsy method. On pathological examination, the lesions extended to the submucosal layer. Therefore, we performed a total gastrectomy with lymph-node dissection. Histologically, the resected specimen showed multiple endocrine cell micronests and carcinoids (sm, n₀) with type-A gastritis. After the operation, the serum gastrin level was normalized. In the treatment of multiple gastric carcinoids and type-A gastritis, total gastrectomy with lymph-node dissection has to be the standard operating procedure, because even minute lesions can cause lymph-node metastasis and distant metastasis, and remnant stomach remain carcinoid.

Key words
multiple gastric carcinoids, type-A gastritis, total gastrectomy

Reprint requests
Akio Machida Higashiyamato Hospital 1-13-12 Nangai, Higashiyamato, 207-0014 JAPAN

Accepted
April 26, 2000

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