Case Report of a Small Gastric Neuroendocrine Tumor in a Deep Layer of Submucosa With Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Treatment With Laparoscopic and Endoscopic Cooperative Surgery
Gastric neuroendocrine tumors (GNETs) are rare lesions characterized by enterochromaffin-like cells of the stomach. Optimal management of GNETs has not yet been definitively determined. Endoscopic resection is approximately recommended for small GNETs associated with hypergastrinemia. However, endos...
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doaj-a326587e803f4c8892fdbdd6bf4def102020-11-25T03:06:52ZengSAGE PublishingClinical Medicine Insights: Case Reports1179-54762018-01-011110.1177/1179547617749226Case Report of a Small Gastric Neuroendocrine Tumor in a Deep Layer of Submucosa With Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Treatment With Laparoscopic and Endoscopic Cooperative SurgeryRyo Igarashi0Atsushi Irisawa1Goro Shibukawa2Nobutoshi Soeta3Ai Sato4Akane Yamabe5Mariko Fujisawa6Noriyuki Arakawa7Yoshitsugu Yoshida8Tsunehiko Ikeda9Yoko Abe10Takumi Maki11Shogo Yamamoto12Ikuro Oshibe13Takuro Saito14Hiroshi Hojo15Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Surgery, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Surgery, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Surgery, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanDepartment of Pathology, Aizu Medical Center, Fukushima Medical University, Fukushima, JapanGastric neuroendocrine tumors (GNETs) are rare lesions characterized by enterochromaffin-like cells of the stomach. Optimal management of GNETs has not yet been definitively determined. Endoscopic resection is approximately recommended for small GNETs associated with hypergastrinemia. However, endoscopic resection might present risk of perforation or positive vertical margin because neuroendocrine tumors occur in the deep mucosa, with some invading the submucosa. In this case, a patient with type A chronic atrophic gastritis had a small subepithelial lesion in a deep submucosal layer, and we diagnosed it as GNET using endoscopic ultrasound-guided fine-needle aspiration biopsy using a forward-viewing and curved linear-array echoendoscope. Moreover, our results show that laparoscopic and endoscopic cooperative surgery with regional lymph node dissection is a safe and feasible procedure for GNETs, especially those that cross to the muscularis propria. We suggest this approach as one therapeutic option for GNETs because it safely minimizes resection and is less invasive.https://doi.org/10.1177/1179547617749226 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ryo Igarashi Atsushi Irisawa Goro Shibukawa Nobutoshi Soeta Ai Sato Akane Yamabe Mariko Fujisawa Noriyuki Arakawa Yoshitsugu Yoshida Tsunehiko Ikeda Yoko Abe Takumi Maki Shogo Yamamoto Ikuro Oshibe Takuro Saito Hiroshi Hojo |
spellingShingle |
Ryo Igarashi Atsushi Irisawa Goro Shibukawa Nobutoshi Soeta Ai Sato Akane Yamabe Mariko Fujisawa Noriyuki Arakawa Yoshitsugu Yoshida Tsunehiko Ikeda Yoko Abe Takumi Maki Shogo Yamamoto Ikuro Oshibe Takuro Saito Hiroshi Hojo Case Report of a Small Gastric Neuroendocrine Tumor in a Deep Layer of Submucosa With Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Treatment With Laparoscopic and Endoscopic Cooperative Surgery Clinical Medicine Insights: Case Reports |
author_facet |
Ryo Igarashi Atsushi Irisawa Goro Shibukawa Nobutoshi Soeta Ai Sato Akane Yamabe Mariko Fujisawa Noriyuki Arakawa Yoshitsugu Yoshida Tsunehiko Ikeda Yoko Abe Takumi Maki Shogo Yamamoto Ikuro Oshibe Takuro Saito Hiroshi Hojo |
author_sort |
Ryo Igarashi |
title |
Case Report of a Small Gastric Neuroendocrine Tumor in a Deep Layer of Submucosa With Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Treatment With Laparoscopic and Endoscopic Cooperative Surgery |
title_short |
Case Report of a Small Gastric Neuroendocrine Tumor in a Deep Layer of Submucosa With Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Treatment With Laparoscopic and Endoscopic Cooperative Surgery |
title_full |
Case Report of a Small Gastric Neuroendocrine Tumor in a Deep Layer of Submucosa With Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Treatment With Laparoscopic and Endoscopic Cooperative Surgery |
title_fullStr |
Case Report of a Small Gastric Neuroendocrine Tumor in a Deep Layer of Submucosa With Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Treatment With Laparoscopic and Endoscopic Cooperative Surgery |
title_full_unstemmed |
Case Report of a Small Gastric Neuroendocrine Tumor in a Deep Layer of Submucosa With Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Treatment With Laparoscopic and Endoscopic Cooperative Surgery |
title_sort |
case report of a small gastric neuroendocrine tumor in a deep layer of submucosa with diagnosis by endoscopic ultrasound-guided fine-needle aspiration and treatment with laparoscopic and endoscopic cooperative surgery |
publisher |
SAGE Publishing |
series |
Clinical Medicine Insights: Case Reports |
issn |
1179-5476 |
publishDate |
2018-01-01 |
description |
Gastric neuroendocrine tumors (GNETs) are rare lesions characterized by enterochromaffin-like cells of the stomach. Optimal management of GNETs has not yet been definitively determined. Endoscopic resection is approximately recommended for small GNETs associated with hypergastrinemia. However, endoscopic resection might present risk of perforation or positive vertical margin because neuroendocrine tumors occur in the deep mucosa, with some invading the submucosa. In this case, a patient with type A chronic atrophic gastritis had a small subepithelial lesion in a deep submucosal layer, and we diagnosed it as GNET using endoscopic ultrasound-guided fine-needle aspiration biopsy using a forward-viewing and curved linear-array echoendoscope. Moreover, our results show that laparoscopic and endoscopic cooperative surgery with regional lymph node dissection is a safe and feasible procedure for GNETs, especially those that cross to the muscularis propria. We suggest this approach as one therapeutic option for GNETs because it safely minimizes resection and is less invasive. |
url |
https://doi.org/10.1177/1179547617749226 |
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