Brief Article
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World J Gastroenterol. Dec 14, 2013; 19(46): 8687-8695
Published online Dec 14, 2013. doi: 10.3748/wjg.v19.i46.8687
Metastatic type 1 gastric carcinoid: A real threat or just a myth?
Simona Grozinsky-Glasberg, Dimitrios Thomas, Jonathan R Strosberg, Ulrich-Frank Pape, Stephan Felder, Apostolos V Tsolakis, Krystallenia I Alexandraki, Merav Fraenkel, Leonard Saiegh, Petachia Reissman, Gregory Kaltsas, David J Gross
Simona Grozinsky-Glasberg, David J Gross, Neuroendocrine Tumor Unit, Endocrinology and Metabolism Service, Department of Medicine, Hadassah-Hebrew University Medical Center, 91120 Jerusalem, Israel
Dimitrios Thomas, Krystallenia I Alexandraki, Gregory Kaltsas, Endocrine Unit, Department of Pathophysiology, National University of Athens, 11527 Athens, Greece
Jonathan R Strosberg, Moffitt Cancer Center, Tampa, FL 33612, United States
Ulrich-Frank Pape, Stephan Felder, Department of Internal Medicine, Division of Hepatology, Gastroenterology, Endocrinology and Metabolism, Charité Universitätsmedizin, DE-13353 Berlin, Germany
Apostolos V Tsolakis, Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, 75185 Uppsala, Sweden
Merav Fraenkel, Institute of Endocrinology, Soroka Ben Gurion University Hospital, 84965 Beer Sheva, Israel
Leonard Saiegh, Institute of Endocrinology, Bnei Zion Hospital, 33394 Haifa, Israel
Petachia Reissman, Department of Surgery, Shaare-Zedek Medical Center, The Hebrew University School of Medicine, 93722 Jerusalem, Israel
Author contributions: Grozinsky-Glasberg S contributed to study concept and design, interpretation of data, drafting of the manuscript, statistical analysis, study supervision; Thomas D, Strosberg JR, Pape UF, Felder S, Tsolakis AV, Alexandraki KI, Fraenkel M and Saiegh L contributed to acquisition of data; Reissman P and Kaltsas G contributed to critical revision of the manuscript; Gross DJ contributed to study concept and critical revision of the manuscript.
Correspondence to: Dr. Simona Grozinsky-Glasberg, MD, Neuroendocrine Tumor Unit, Endocrinology and Metabolism Service, Department of Medicine, Hadassah-Hebrew University Medical Center, PO Box 12000, 91120 Jerusalem, Israel. simonag@hadassah.org.il
Telephone: +972-2-6776788 Fax: +972-2-6437940
Received: June 17, 2013
Revised: August 25, 2013
Accepted: September 3, 2013
Published online: December 14, 2013
Processing time: 183 Days and 16.9 Hours
Core Tip

Core tip: Metastatic gastric carcinoid type 1 (GCA1) are extremely rare and there is no data regarding their natural history, treatment and prognosis. Based on our study, metastatic GCA1 carries a good overall prognosis. Metastatic spread appears to be related to a tumor size of ≥ 1 cm, an elevated Ki-67 index, and to high serum gastrin levels. Endoscopic surveillance is extremely important for follow-up. Surgical resection should be performed only in patients in whom total tumor excision is expected. Although still controversial, somatostatin analogues could be considered as first line treatment to lower the elevated gastrin levels and suppress enterochromaffin like cell hyperplasia.