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DOI: 10.1055/s-0029-1233975
© Georg Thieme Verlag KG Stuttgart · New York
(Neuro-)Endokrine Tumoren des Magens sind auf dem Vormarsch: Gute Prognose bei frühem Nachweis
Neuroendocrine tumors of the stomach (gastric carcinoids) are on the rise: good prognosis if early detectedPublication History
eingereicht: 11.2.2009
akzeptiert: 10.6.2009
Publication Date:
14 July 2009 (online)
![](https://www.thieme-connect.de/media/dmw/200930/lookinside/thumbnails/10.1055-s-0029-1233975-1.jpg)
Zusammenfassung
Neuroendokrine Tumoren (NET) des Magens sind auf dem Vormarsch: in den USA haben sie in den letzten 35 Jahren um ca. 1000 % an Häufigkeit zugenommen. Zeitgleich hat sich aber die Prognose der Patienten wesentlich verbessert, da die Mehrzahl dieser Tumoren heutzutage in einem frühen Stadium festgestellt wird. Nicht selten erfolgt die Diagnose „en passant” im Rahmen einer Gastroskopie, die unter anderer Fragestellung durchgeführt wurde. Die meisten dieser asymptomatischen, gut differenzierten Magen NET sind kleiner als 2 cm im Durchmesser. Gut differenzierte, multifokale neuroendokrine Tumoren (sog. Typ-1- oder Typ-2-Karzinoide) des Magens von ≤ 10 – 20 mm Größe, die nicht angioinvasiv wachsen, nicht die Muscularis propria infiltrieren und nicht metastasiert haben, sollen konservativ behandelt und endoskopisch überwacht werden. Für die Bestimmung der Größe und Infiltrationstiefe der NET und zum Nachweis von Lymphknotenmetastasen ist die Endosonographie die Methode der Wahl. Eine Operationsindikation besteht bei allen NET größer als 2 cm. Für die Therapieempfehlung müssen Tumorbiologie, Tumortyp, Tumorstadium und die individuelle Situation berücksichtigt werden. Die überwiegende Mehrzahl der Patienten kann konservativ geführt und endoskopisch überwacht werden.
Abstract
Neuroendocrine tumors (NET) of the stomach are on the rise. In the United States they have increased about tenfold in the last 35 years. Prognosis has been much improved over the last three to four decades. Nowadays most of such NETs are diagnosed at an early stage. Quite often gastric NETs are found incidentally during a gastroscopy, performed for other reasons. Most of the asymptomatic, well differentiated gastric NETs are less than 2 cm in diameter. Conservative management and endoscopic surveillance is adequate for well differentiated, multifocal type 1 or type 2 gastric NETs (gastric carcinoids) of 10-20 mm , unless they are angio-invasive, have infiltrated into the muscularis propria or have metastasized. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. Surgery is, however, indicated for all NETs larger than 20 mm. For optimal management tumor biology, type and stage of the neoplasm as well as the individual situation of the patient have to be taken into account. Most of the patients can be treated conservatively and be followed up with endoscopic surveillance.
Schlüsselwörter
endokrine Tumoren - Karzinoid - Karzinom - Neoplasie - Früherkennung - Gastritis
Keywords
neuroendocrine tumors - carcinoid - cancer - neoplasm - screening - gastritis
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Prof. Dr. med. Hans Scherübl
Klinik für Innere Medizin -Gastroenterologie
und Gastrointestinale Onkologie, Vivantes-Klinikum Am Urban
Dieffenbachstrasse 1
10967 Berlin
Phone: 030/130225201
Fax: 030/130225205
Email: hans.scheruebl@vivantes.de