ENDOSKOPİDE NADİR RASTLANAN POLİPLER: TİP 1 GASTRİK NÖROENDOKRİN TÜMÖR NET-TİP 1

Yıl 2014, Cilt: 18 Sayı: 4, 121 - 125, 01.12.2014

Erkan Oymacı¹ Erdem Sarı² Ahmet Deniz Uçar² Savaş Yakan Fulya Yilmaz Duran³ Nazif Erkan² Enver Vardar Mehmet Yıldırım

Öz

Mide nöroendokrin tümörleri nadir görülür ancak sıklığı gittikçe artmaktadır. Bu tümörler enterokromaffin benzeri hücrelerden köken alırlar. Tüm GIS nöroendokrin tümörleri içerisinde % 3 oranında görülürler. Klinik görünümü genellikle nonspesifiktir. Gastrik nöroendokrin tümörler ile pernisiyöz anemi, atrofik gastrit ve Zollinger-Ellison sendromu arasında bir birliktelik söz konusudur. Hastalarda polipoid lezyonlar tek ya da çok sayıda olabilir, ancak mukoza ve submukozada sınırlıdırlar. Üç tip mide nöroendokrin tümörü tanımlanmıştır. Tip1 ve Tip2 mide nöroendokrin tümörler hipergastrinemi ile ilişkilidir ve genellikle düşük metastaz potansiyeline sahiptirler. Tip3 mide nöroendokrin tümörler hipergastrinemi ile ilişkisizdir ve yüksek metastaz potansiyeline sahiptirler. Tip 1 ve Tip 2 mide nöroendokrin tümörler çoğunlukla multifokaldir, ancak Tip 3 tümörler genellikle soliter tümörlerdir. Mide nöroendokrin tümörün gelişiminden gastrin, genetik faktörler, büyüme faktörleri ve matriks regülasyon proteinleri gibi birçok faktör sorumlu tutulmuştur. Tedavi öncesi uygun bir değerlendirme, gastrik adenokarsinom ve displazi gibi eş zamanlı lezyonların varlığı kadar malign dönüşümlerin de ekarte edilebilmesi için gereklidir. Çalışmamızda, kronik atrofik gastrit zemininde gelişmiş ve endoskopik olarak rezeke edilmiş, NET-Tip1 polip olgusunu sunuyoruz

Anahtar Kelimeler

Nöroendokrin tümör NET, gastrik polip, gastroskopi

RARE POLYPS IN ENDOSCOPIC EXAMINATION: TYPE 1 GASTRIC NEUROENDOCRIN TUMOUR NET-TYPE 1

Öz

Gastric neuroendocrine tumors are rare, but are increasing in occurrence. These tumors originate from enterochromaffin-like cells. These tumors are less than 3 % of all gastrointestinal neuroendocrine tumors.The clinical presentation is often non-specific. There is a definitive association between the occurrence of gastric neuroendocrine tumors and pernicious anemia, atrophic gastritis and Zollinger-Ellison syndrome. These patients had single or multiple polypoid lesions with tumor extension limited to mucosa or submucosa. Three subtypes of gastric neuroendocrine tumors were defined. Types 1 and 2 gastric neuroendocrine tumors are associated with hypergastrinemia and usually have low metastatic potential. Type 3 gastric neuroendocrine tumors are not associated with hypergastrinemia and have a higher potential for metastatic disease. Most of types 1 and 2 gastric neuroendocrine tumors are multifocal; however type 3 tumors are often solitary tumors. The development of a gastric neuroendocrine tumor has been responsible for many factors such as gastrin, genetic factors growth factors and matrix regulating proteins. A proper evaluation before therapy is indicated in order to rule out both the malignant transformation as well as the presence of synchronous lesions, such as dysplasia or gastric adenocarcinoma. We presented NET type-1 gastric polyp case which improved on the base of chronic atrophic gastritis and endoscopically resected during gastroscopic intervention

Anahtar Kelimeler

Neuroendocrine tumor NET, Gastric polyp, gastroscopy

Kaynakça

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