Frontiers in Medicine (Jan 2024)

Type 3 gastric neuroendocrine neoplasms: the rising promise of conservative endoscopic management

  • Elisabetta Dell’Unto,
  • Elisabetta Dell’Unto,
  • Gianluca Esposito,
  • Gianluca Esposito,
  • Maria Rinzivillo,
  • Matteo Marasco,
  • Matteo Marasco,
  • Matteo Marasco,
  • Bruno Annibale,
  • Bruno Annibale,
  • Francesco Panzuto,
  • Francesco Panzuto

DOI
https://doi.org/10.3389/fmed.2024.1327864
Journal volume & issue
Vol. 11

Abstract

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Gastric neuroendocrine neoplasms (g-NENs) are rare tumors arising from the gastric enterochromaffin-like cells. Recent data suggests an increased detection rate, attributed to more frequent esophagogastroduodenoscopies. While type 3 g-NENs were historically deemed aggressive, emerging research indicates potential for conservative management, especially endoscopic resection, in well-differentiated, small tumors. European guidelines now advocate for endoscopic intervention in selected cases, but North American guidelines remain more conservative. Key factors influencing outcomes are tumor size, grading, and depth of gastric wall infiltration. Endoscopic resection has shown promise for tumors confined to submucosal layers without lymphovascular invasion. Given the complexities, a multidisciplinary team approach is essential for management decisions. Current insights are largely based on retrospective studies, underscoring the need for prospective research to optimize endoscopic approaches.

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