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Neuroendocrine neoplasia can occur throughout the gastrointestinal tract and are diverse in their clinical presentation. What they have in common is that they can be either hormonally active (functional) or hormonally inactive (non-functional). NENs are further divided into neuroendocrine tumors (NET; well differentiated) and neuroendocrine carcinomas (NEC; poorly differentiated) according to their morphological appearance and proliferation rate. In the case of a NET, a further distinction is made between tumors G1 (with a proliferation <3%), G2 (proliferation rate 3-20%) and G3 (proliferation rate >20%). The treatment depends on the origin, functionality, size, location and grading.
The clinical symptoms are extremely complex and variable.
I had a gastroscopy for a check-up and a neuroendocrine tumor was biopsied, what happens next?
Small neuroendocrine tumors of the stomach occur relatively frequently in the context of atrophic gastritis. This is an autoimmune disease directed against specific acid-producing cells in the stomach and therefore the gastric juice becomes too alkaline. The neighboring cells, in turn, try to stimulate the stomach acid-producing cells to produce acid and thereby grow into small neuroendocrine tumors. These small, slow-growing tumors generally do not require any therapy, but annual follow-up gastroscopy is necessary because in rare cases gastric cancer may develop. In contrast, there are also rapidly growing malignant neuroendocrine neoplasms of the stomach; these differ significantly in their biology due to a significantly higher proliferation rate and must be treated quickly.