[Gastric neuroendocrine neoplasms: update on endoscopic and surgical management]

For type I gastric neuroendocrine neoplasms (gNEN) larger than 1 cm endoscopic resection should be performed, whereas for tumors larger than 2 cm surgical resection should be carried out. Tumors between 1 and 2 cm in size are generally resected endoscopically following endosonography; however, surgery should be considered in the presence of risk factors such as G2/3 tumors, infiltration of the muscularis propria and vascular invasion. Type II gNENs are treated endoscopically or surgically in the same manner as type I tumors. It is essential to consider treatment of the underlying hypergastrinemia caused by duodenal wall gastrinomas as well as treatment of any potentially concurrent primary hyperparathyroidism (pHPT). For type III gNENs surgical resection is generally recommended. In selected patients with very rare, small (< 1 cm) G1 tumors, endoscopic resection can be appropriate.