1997 Volume 58 Issue 7 Pages 1504-1508
We experienced a case of multiple carcinoid of the stomach with hypergastrinemia and type A gastritis in a 35-year-old man. Upper gastrointestinal series revealed an about 1cm polyp of Yamada's type II or III in the posterior wall of the upper body of the stomahc adjacent to the greater curvature and multiple minute polyps ranging from the upper body to fornix. All polyps were diagnosed as carcinoid on endoscopic biopsy. Ultrasonic endoscopy revealed that the lesions were localized in the submucosal layer. Serum gastrin level was as high as 1, 950pg/ml.Total gastrectomy was carried out and multiple gastric carcinoids (sm, n0) with type A gastritis were histologically confirmed. After the operation, serum gastrin level was normalized and the patient has been doing well as of 3 years or more after the operation.
In the treatment of multiple gastric carcinoid with type A gastritis, total gastrectomy with lymph node dissection would have to be the standard operative procedure, in order to resect the fundic gland area completely which can be the origin of carcinoids and endocrine cell micronest.
