[Gastric carcinoid--pathogenesis and treatment]

Gastric carcinoid tumours are rare neoplasms of neuroendocrine origin. They are believed to grow from enterochrommaffin-like (ECL) cells. Three different types of tumours can be distinguished: type I: hypergastrinaemic, induced by achlorhydria in chronic atrophic gastritis; type II: hypergastrinaemic, associated with Zollinger-Ellison syndrome and multiple endocrine neoplasia syndrome type 1; type III: sporadic. The trophic effect of gastrin on ECL cells is of crucial importance in the pathogenesis and treatment of hypergastrinaemic carcinoids. In these patients, hypergastrinaemia leads to ECL-hyperplasia, -dysplasia and -neoplasia. Hypergastrinaemic carcinoids often follow a very benign course, which makes it possible to avoid surgery, at least in patients at high surgical risk. The management of these three types is discussed.