Detection of small-bowel neuroendocrine tumors by video capsule endoscopy.
OBJECTIVE
Carcinoid tumors are the most common GI neuroendocrine tumors (NET). They often originate in the small intestine. The primary tumor is often difficult to locate, and resection in an early phase is recommended to prevent complications. This study evaluated the value of videocapsule endoscopy (VCE) in the detection of small-intestinal primary carcinoid tumor.


METHODS
Prospective descriptive study.


METHODS
Tertiary referral center.


METHODS
Twenty consecutive patients (13 men, 7 women; 60.5 +/- 9.3 years) with metastatic NET of unknown primary tumor.


METHODS
All patients underwent CT, enteroclysis, nuclear imaging, and VCE of the small bowel.


RESULTS
CTs and enteroclysis did not detect a primary small-intestinal carcinoid tumor. Nuclear imaging demonstrated abnormalities in the abdominal area in 13 patients but was unable to relate this to an intestinal localization in any patient. VCE revealed a small-intestinal tumor in 9 patients. Three other patients showed external compression and erosions. At surgery, 5 patients had a small-intestinal carcinoid tumor, and, in 2 patients, a small-intestinal ischemic segment was present.


CONCLUSIONS
The number of false-positive VCE findings was not clear, because not all patients underwent surgery. The absence of abnormalities at VCE in patients with abnormalities at nuclear imaging might be related to the presence of carcinoid tumor restricted to the mesenterium or to a false-negative VCE.


CONCLUSIONS
VCE had a high diagnostic yield of 45% for identification of primary small-intestinal carcinoid tumors. Although nuclear imaging had a comparable diagnostic yield, it could not differentiate between intestinal and mesenterial localization of the carcinoid.
van Tuyl
Sebastiaan A C
SA
Department of Gastroenterology, St. Antonius Hospital, 3430 EM Nieuwegein, The Netherlands.
van Noorden
Jacco Tenthof
JT
Timmer
Robin
R
Stolk
Mark F J
MF
Kuipers
Ernst J
EJ
Taal
Babs G
BG
D000328:Adult; D000368:Aged; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000032:analysis; D007205:Indium Radioisotopes; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D007457:Iodine Radioisotopes; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed
D007205:Indium Radioisotopes; D007457:Iodine Radioisotopes; D006897:Hydroxyindoleacetic Acid