Multiple gastric carcinoid tumours with lymphoduct infiltration : a case report

Abstract

Multiple gastric carcinoid tumours are a well-recognised complication of hypergastrinaemia associated with chronic atrophic gastritis. However, the management of such tumours remains undetermined, with the decision either antrectomy or total gastrectomy being empirical, though the antrectomy has been preferred in recent reports because of the malignant potential of such carcinoids being putatively of modest concern. This report describes a case of multiple gastric carcinoid tumours (located in fornix to corpus, size＜5mm) arising in type A chronic gastritis. A total gastrectomy was performed because of the patient's strong request, after which the patient made an uneventful recovery. Histopathological findings revealed that a lymphoduct was infiltrated by chromogranin A-positive carcinoid cells (ly1) , although the carcinoid tumours themselves were relatively small and early in stage (sm1) . Lymphoduct infiltration may lead to future distant metastasis if preserved, and we conclude that the treatment for multiple gastric carcinoids should be of further discussion.