Management of Gastric Neuroendocrine Tumors: A Review

Ann Surg Oncol. 2024 Mar;31(3):1509-1518. doi: 10.1245/s10434-023-14712-9. Epub 2023 Dec 7.

Abstract

Gastric neuroendocrine tumors (G-NET) are rare tumors arising from enterochromaffin-like cells of the gastric mucosa. They belong to a larger group called gastroenteropancreatic neuroendocrine tumors and are classified as low, intermediate, or high-grade tumors based on their proliferative indices. They are further categorized into three subtypes based on their morphologic characteristics, pathogenesis, and behavior. Types 1 and 2 tumors are characterized by elevated serum gastrin and are usually multifocal. They typically occur in the setting of atrophic gastritis or MEN1/Zollinger Ellison syndrome, respectively. Type 2 tumors are associated with the most symptoms, such as abdominal pain and diarrhea. Type 3 tumors are associated with normal serum gastrin, are usually solitary, and occur sporadically. This type has the most aggressive phenotype and metastatic potential. Treatment and prognosis for G-NET is dependent on their type, size, and stage. Type 1 has the best prognosis, and Type 3 has the worst. This review discusses the presentation, workup, and surgical management of these tumors.

Keywords: GNET; Gastric neuroendocrine; Gastrinoma; High-grade; NET; Neuroendocrine carcinoma.

Publication types

  • Review

MeSH terms

  • Gastric Mucosa / pathology
  • Gastrins
  • Humans
  • Neuroendocrine Tumors* / pathology
  • Pancreatic Neoplasms* / surgery
  • Stomach Neoplasms* / pathology
  • Zollinger-Ellison Syndrome* / pathology

Substances

  • Gastrins