A case of multiple gastric carcinoid associated with hypergastrinemia

We report a case of multiple gastric carcinoid with hypergastrinemia. A 38-year-old man found to have an abnormality of the stomach in a medical check up was found in gastric endoscopy to have multiple polyps from the gastric fornix to the middle gastric body. Polyp biopsy showed them to be carcinoid, so he referred to our hospital for further study. Laboratory data showed hypergastrinemia (serum gastrin of 800pg/dl), but normal serum serotonin. Acid endocrine test by gastroscopy shows no acid pattern. Endosonography showed the depth of invasion to be submucosal layer, so we conducted total gastrectomy with lymph node dissection due to the possibility of lymph node metastasis. Histological examination reveals the three largest polyps as carcinoid, and the other polyps as hyperplastic polyp. Also it reveals the maximum carcinoid as sm, n0, v1 and ly0, and the other carcinoids as m. Postoperative laboratory data showed that the serum gastrin had normalized (25pg/ml). To determine therapy for gastric carcinoid. we must consider factors such as size and depth of invasion.