多発性胃カルチノイドの１例

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  • A Case of Multiple Gastric Carcinoids.

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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 lymphnode 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 lymphnode 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.

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