Carcinoids of the stomach. Report of two cases

Endoscopic, histologic and clinical findings of two cases with disseminated carcinoids restricted to the stomach are described. Endoscopically different forms of polypoid lesions were observed: 1. polypoid type of Yamada III, usually seen in epithelial tumors; 2. small lesions elevated with bridging folds and 3. slightly elevated types with necrotic surface similar to an early stage of cancer. An exact diagnosis is possible with sections obtained by polypectomy, button-hole-biopsy or by hot-biopsy. There are some problems in interpreting the histology, especially the differentiation from carcinomas. Carcinoids limited to the stomach do not produce typical clinical symptoms. 5-HIA and serotonin levels in the thrombocytes are in the normal range. Since surgical procedures depend upon the exact localization and the invasive or noninvasive morphological character, endoscopy with polypectomy is of great help in assessing the pathology as well as the necessity for surgery.