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Carcinoid tumors of the gastrointestinal tract: evaluation with endoscopic ultrasonography
H Yoshikane1, Y Tsukamoto, Y Niwa
1Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Abstract:
To evaluate the usefulness of endoscopic ultrasonography for carcinoid tumors, we examined 29 patients with gastrointestinal carcinoid tumors (5 gastric, 7 duodenal, and 17 rectal). The smallest size detectable by endoscopic ultrasonography was 2 mm in diameter histologically. The cross-sectional image of the tumors was primarily oval to round. The internal echo was generally hypoechoic and homogeneous. The margins were clearly visualized, and the contour was somewhat smooth. The tumors were mainly located in the third layer. The second layer covered the tumor with the third layer at its base, and it abutted the tumor and became indistinct near its upper interface. These findings were especially recognized in lesions with submucosal invasion and were similar at all sites. The overall accuracy of determining the depth of invasion using endoscopic ultrasonography was 75% (27 of 36 lesions). Limited to the lesions detectable by endoscopic ultrasonography, the accuracy was 90%. Endoscopic ultrasonography was useful in determining the presence of local metastases. Moreover, endoscopic ultrasonography allowed direct detection of perigastrointestinal lymph node metastases (75%, three of four patients). In conclusion, endoscopic ultrasonography was found to be useful for the staging of gastrointestinal carcinoid tumors by determining depth of involvement and presence of perigastrointestinal lymph node metastases.
Insights
Endoscopic ultrasonography (EUS) is valuable for staging gastrointestinal carcinoid tumors. It accurately determines tumor invasion depth and detects lymph node metastases, aiding treatment decisions.
Area of Science:
- Gastroenterology
- Medical Imaging
- Oncology
Background:
- Gastrointestinal carcinoid tumors are rare neoplasms.
- Accurate staging is crucial for effective treatment planning.
Purpose of the Study:
- To assess the utility of endoscopic ultrasonography (EUS) in evaluating gastrointestinal carcinoid tumors.
- To determine EUS accuracy in assessing tumor invasion depth and lymph node metastasis.
Main Methods:
- Retrospective analysis of 29 patients with gastrointestinal carcinoid tumors.
- Evaluation of EUS findings including tumor size, shape, echogenicity, and layer of origin.
- Correlation of EUS findings with histological data to determine accuracy.
Main Results:
- EUS detected tumors as small as 2 mm.
- Tumor characteristics included oval to round shape, hypoechoic echogenicity, and location primarily in the third layer.
- Overall accuracy for depth of invasion was 75% (90% for detectable lesions).
- EUS identified perigastrointestinal lymph node metastases in 75% of cases.
Conclusions:
- Endoscopic ultrasonography is a useful tool for staging gastrointestinal carcinoid tumors.
- EUS aids in determining tumor invasion depth and detecting lymph node metastases.
- EUS findings can guide clinical management and treatment strategies.