A Case of Small Gastric Carcinoid Tumor with Lymph Node Metastasis -Usefullness of Sentinel Node Navigation Surgery-

Nobutoshi Soeta, Masanori Terashima, Michihiko Kogure, Yutaka Hoshino, Seigo Kashimura, Satoshi Ohtani, Youko Odashima, Takashi Igarashi and Mitsukazu Gotoh

Department of Surgery I, Fukushima Medical University

We report a case of a small gastric carcinoid tumor with lymph node metastasis in a 59-year-old woman. Gastro- intestinal endoscopy showed a small torous lesion (about 10 mm long) in the gastric body, which endoscopic biopsy showed to be a carcinoid tumor. Serum gastrin was 2,069 pg/ml. Endoscopic ultrasoundscopy showed invasion to the submucosa, necessitating surgery. Using sentinel node navigation surgery (SNNS), we found two sentinel lymph nodes (No 4d) with metastasis found pathologically in one. We conducted distal gastrectomy with D2 lymph node dissection. Pathologically, the tumor was diagnosed as a carcinoid tumor (9 mm long) invading the submucosa (SM2). No lymph nodes metastasis was seen aside from the sentinel lymph node. No chronic atrophic gastritis was seen in the resected stomach. Serum gastrin decreased to within normal limits following surgery. The incidence of lymph node metastasis in gastric carcinoid tumors invading the submucosa is almost identical to that in gastric cancer invading the submucosa. SNNS thus appears useful in diagnosing lymph node metastasis accurately during surgery for gastric carcinoid tumors.

Key words
gastric carcinoid tumor, hypergastrinemia, sentinel node navigation surgery

Reprint requests
Nobutoshi Soeta Department of Surgery I, Fukushima Medical University
1 Hikarigaoka, Fukushima, 960-1295 JAPAN

Accepted
February 22, 2006

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