Clinical Scorecard: Endoscopic Submucosal Dissection with Intentional Muscularis Propria Exposure for Successful Resection of a Large Type 1 Gastric Neuroendocrine Tumor: A Case Study

At a Glance

Key Highlights

• Case of a 48-year-old female with a 2.5 cm G2 grade type 1 gNET
• Markedly elevated serum gastrin level (3100 pg/mL)
• Successful en bloc resection using ESD-MPE technique
• Final pathology confirmed pT1b, G2 NETs with negative margins
• Demonstrates potential for minimally invasive treatment in selected cases

Guideline-Based Recommendations

Diagnosis

• Comprehensive staging with endoscopic ultrasound and 68Ga-DOTATATE PET/CT
• Histopathological confirmation of type I gNET

Management

• Endoscopic resection individualized based on imaging findings
• Consideration of non-surgical management with PPIs or SSAs

Monitoring & Follow-up

• Lifelong endoscopic surveillance post-surgery for ECL cell hyperplasia

Risks

• Surgical interventions may lead to irreversible gastric dysfunction

Patient & Prescribing Data

Female, 48 years old, with elevated gastrin levels and diagnosed type I gNET

Endoscopic resection techniques tailored to tumor location and characteristics

Clinical Best Practices

• Utilize a multidisciplinary team for comprehensive patient evaluation
• Employ advanced endoscopic techniques for tumor resection
• Ensure thorough preoperative staging to guide management decisions

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