2007 Volume 49 Issue 11 Pages 2839-2845
On gastroscopy a 49-year-old male was found to have a type IIc+IIa early cancer located in the posterior wall of the upper gastric body. A carcinoid tumor was diagnosed based on the biopsied specimen. Double contrast gastrography showed a depressed lesion with a marginal elevation that resembled early gastric cancer. Endoscopic ultrasound showed a low echoic tumor predominantly located in the 2 nd to 3 rd layer. A diagnosis of gastric carcinoid tumor with an SM2 depth of invasion was maid. Thus, a gastrectomy with lymph node dissection was recommended. However, the patient wished to have the this tumor resected endoscopically . On histological examination of the resected tumor, a typical carcinoid findings with a high degree of atypia and a high Ki-67 labeling index were noted. The severe mucosal atrophy with serum hypergastrinemia endoscopically was confirmed on histology. The serum anti-parietal cell antibody was negative and the patient did not have an anemia. The pepsinogen I/Ii ratio and the serum gastrin level normalized after successful eradication of Helicobacter pylori . It is likely that our patient's sporadic type of type-III carcinoid tumor (Rindi's classification), which occurred due to the presence of severe atrophic gastric mucosa and serum hypergastrinemia induced by Helicobacter pylori infection.
