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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Apr 16, 2015; 7(4): 346-353
Published online Apr 16, 2015. doi: 10.4253/wjge.v7.i4.346
Endoscopic diagnosis and management of type I neuroendocrine tumors
Yuichi Sato
Yuichi Sato, Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8121, Japan
Author contributions: Sato Y solely contributed to this manuscript.
Conflict-of-interest: The author declares that no financial or other conflicts of interest exist in relation to the content of this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yuichi Sato, MD, Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata 951-8121, Japan. yuichi@med.niigata-u.ac.jp
Telephone: +81-25-2272207 Fax: +81-25-2270776
Received: September 5, 2014
Peer-review started: September 6, 2014
First decision: November 27, 2014
Revised: December 9, 2014
Accepted: January 9, 2015
Article in press: January 12, 2015
Published online: April 16, 2015
Processing time: 225 Days and 19.2 Hours
Abstract

Type I gastric neuroendocrine tumors (TI-GNETs) are related to chronic atrophic gastritis with hypergastrinemia and enterochromaffin-like cell hyperplasia. The incidence of TI-GNETs has significantly increased, with the great majority being TI-GNETs. TI-GNETs present as small (< 10 mm) and multiple lesions endoscopically and are generally limited to the mucosa or submucosa. Narrow band imaging and high resolution magnification endoscopy may be helpful for the endoscopic diagnosis of TI-GNETs. TI-GNETs are usually histologically classified by World Health Organization criteria as G1 tumors. Therefore, TI-GNETs tend to display nearly benign behavior with a low risk of progression or metastasis. Several treatment options are currently available for these tumors, including surgical resection, endoscopic resection, and endoscopic surveillance. However, debate persists about the best management technique for TI-GNETs.

Keywords: Gastric neuroendocrine tumor; Narrow band imaging; Magnifying endoscopy; Endoscopic submucosal dissection; Endoscopic surveillance

Core tip: The incidence of type I gastric neuroendocrine tumors (TI-GNETs) has significantly increased, TI-GNETs are the most frequently diagnosed of all GNETs, accounting for about 70%-80%. Endoscopically, TI-GNETs are present as small (< 10 mm), polypoid lesions or, more frequently, as smooth, rounded submucosal lesions. Especially, narrow band imaging and high resolution magnification endoscopy may be helpful for the endoscopic diagnosis of TI-GNETs. TI-GNETs tend to display a nearly benign behavior and a low risk of progression or metastasis in spite of submucosal invasion. Therefore, endoscopic submucosal dissection is a feasible technique for the removal of TI-GNETs.