title: The role of 68-Ga-DOTATOC CT-PET in surgical tactic for gastric neuroendocrine tumors treatment: our experience: a case report.
abstract: Gastric neuroendocrine tumors (g-NETs), which originate from gastric enterochromaffin-like (ECL) mucosal cells and account for 2.4% of all carcinoids, are increasingly recognized due to expanding indications of upper gastrointestinal endoscopy. Often silent and benign, g-NETs may however, be aggressive and sometimes they mimic the course of gastric adenocarcinoma. Current nosography distinguishes those occurring in chronic conditions with hypergastrinemia, as the type 1 associated with chronic atrophic gastritis, and the type 2 associated with Zollinger-Ellison syndrome in MEN1. Conversely, type 3 and 4 (according to some authors) are unrelated to hypergastrinemia and are frequently malignant, with a propension to develop distant metastases. While there is a general agreement concerning the treatment of malignant gastric neuroendocrine tumors, for types 1 and 2, current possibilities include surveillance, endoscopic polypectomy, surgical excision, associated or not with surgical antrectomy, or total gastrectomy. This report, based on our clinical experience, discusses how the size, number, depth, histological grading, staging with CT, MRI, and the use of recently developed somatostatin receptor tracers (68Ga-DOTATATE, 68Ga-DOTA-TOC) could allow the correct identification of a benign or malignant propensity of an individual tumor, thus avoiding underestimation or overtreatment of these uncommon neoplasms.
authors.affiliation: General Surgery and Senology Unit, Department of Surgery, "Policlinico - Vittorio Emanuele" Hospital, University of Catania Medical School, Via S. Sofia 78, 95123 Catania, Italy. Electronic address: andreacavallaro@tiscali.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cavallaro
authors.affiliation: General Surgery and Senology Unit, Department of Surgery, "Policlinico - Vittorio Emanuele" Hospital, University of Catania Medical School, Via S. Sofia 78, 95123 Catania, Italy. Electronic address: amzanghi@unict.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Zanghì
authors.affiliation: Radiology Unit, Guzzardi Hospital, Via Papa Giovanni XXIII, 97019 Vittoria (RG) Italy. Electronic address: cavallaromarco82@virgilio.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Cavallaro
authors.affiliation: Section of Minimally Invasive and Endoscopic Surgery, Cleveland Clinic Florida, Weston, FL, USA. Electronic address: elomenzo@hotmail.com.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Lo Menzo
authors.affiliation: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, Catania, Italy. Electronic address: idicarlo@unict.it.
authors.forename: Isidoro
authors.initials: I
authors.lastname: Di Carlo
authors.affiliation: General Surgery and Senology Unit, Department of Surgery, "Policlinico - Vittorio Emanuele" Hospital, University of Catania Medical School, Via S. Sofia 78, 95123 Catania, Italy. Electronic address: divitama@unict.it.
authors.forename: Maria
authors.initials: M
authors.lastname: Di Vita
authors.affiliation: General Surgery and Senology Unit, Department of Surgery, "Policlinico - Vittorio Emanuele" Hospital, University of Catania Medical School, Via S. Sofia 78, 95123 Catania, Italy. Electronic address: f.cardi@unict.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cardì
authors.affiliation: General Surgery and Senology Unit, Department of Surgery, "Policlinico - Vittorio Emanuele" Hospital, University of Catania Medical School, Via S. Sofia 78, 95123 Catania, Italy. Electronic address: schaky@hotmail.it.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Piccolo
authors.affiliation: General Surgery and Senology Unit, Department of Surgery, "Policlinico - Vittorio Emanuele" Hospital, University of Catania Medical School, Via S. Sofia 78, 95123 Catania, Italy. Electronic address: dimattiapaolo@libero.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Mattia
authors.affiliation: General Surgery and Senology Unit, Department of Surgery, "Policlinico - Vittorio Emanuele" Hospital, University of Catania Medical School, Via S. Sofia 78, 95123 Catania, Italy. Electronic address: alecap@unict.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cappellani
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005708:Gallium; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000601:surgery; D015282:Octreotide / Q000031:analogs & derivatives; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography / Q000379:methods*; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D009942:Organometallic Compounds; C513399:gallium Ga 68 dotatate; D005708:Gallium; D015282:Octreotide; C106246:Edotreotide
keywords: Dotatate; Dotatoc; Gastric carcinoids; Gastric lymphadenectomy; Neuroendocrine gastric tumors; g-net