title: Review article: Pathogenesis and management of gastric carcinoid tumours.
abstract: BACKGROUND
  Gastric carcinoid tumours are rare, but are increasing in incidence.
  
  
  OBJECTIVE
  To discuss tumour pathogenesis and outline current approaches to patient management.
  
  
  METHODS
  Review of published articles following a Pubmed search.
  
  
  RESULTS
  Although interest in gastric carcinoids has increased since it was recognized that they are associated with achlorhydria, to date there is no definite evidence that humans taking long-term acid suppressing medication are at increased risk. Type I tumours are associated with autoimmune atrophic gastritis and hypergastrinaemia, type II are associated with Zollinger-Ellison syndrome, multiple endocrine neoplasia-1 and hypergastrinaemia and sporadic type III carcinoids are gastrin-independent and carry the worst prognosis. Careful investigation of these patients is required, particularly to identify the tumour type, the source of hypergastrinaemia and the presence of metastases. Treatment can be directed at the source of hypergastrinaemia if type I or II tumours are still gastrin responsive and not growing autonomously. Type III tumours should be treated surgically.
  
  
  CONCLUSIONS
  Advances in our understanding of the pathogenesis of gastric carcinoids have led to recent improvements in investigation and management. Challenges remain in identifying the genetic and environmental factors, in addition to hypergastrinaemia, that are responsible for tumour development in susceptible patients.
authors.affiliation: Division of Gastroenterology, Liverpool University, Liverpool, UK.
authors.forename: M D
authors.initials: MD
authors.lastname: Burkitt
authors.forename: D M
authors.initials: DM
authors.lastname: Pritchard
mesh_terms: D002276:Carcinoid Tumor / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D013274:Stomach Neoplasms / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome