The endoscopic diagnosis and treatments of 44 cases of gastrointestinal carcinoid tumor

Objective: To study the endoscopic features and treatment of gastrointestinal carcinoids. Methods: Data of 44 gastrointestinal carcinoid patients from 2002 to 2009 were analyzed retrospectively. And the clinical manifestation, endoscopic diagnosis, endoscopic treatment and prognosis were summarized. Results: The main symptoms were abdominal pain, changes in bowel habits, bloody stool and no any symptoms. Most of the lesions were elevated lesions with normal mucosal appearance. The pit patterns of them were pit I. Some big lesions were like polyps with the pit III. Seldom are malignant carcinoids with the pit V. Endoscopic ultrasonography (EUS)were performed in 29 patients and all the lesions were presented as submucosal hypoechoic masses. Most of them were homogeneous echo and distinct border on Endoscopic ultrasonography. Twelve patients accepted endoscopic fulguration with high frequency current (FHFC) and 32 patients accepted endoscopic mucosal resection (EMR). 1 patient accepted supplemental local resection. During the follow-up visit of 3 months -5 years, none positive for recurrent tumor. Conclusion: Gastrointestinal carcinoid tumors lack of characteristic features of clinical symptoms, diagnosis depends on endoscopy and pathology. The pit patterns of them were pit I and pit III. Malignant carcinoids were pit V. For lesion less then 1cm, the FHFC and EMR were safe and effective procedure to treat them. If the lesion >1cm and the muscle layer were no infiltration, the EMR is the best method to treat them.

Keywords: gastrointestinal carcinoid; Diagnosis; Treatment; Endoscopy