Cardioesophageal carcinoid: multidisciplinary approach to diagnosis

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Abstract

Cardioesophageal carcinoid is a rare neuroendocrine neoplasm. Diagnosis and treatment are especially difficult in case of proximal localization of the gastric lesion (in the region of cardia) which requires a complex multidisciplinary approach. The clinical presentation of gastric  carcinoid is in most cases nonspecific, and the tumor is accidentally detected in endoscopic exa-mination for the pain syndrome, dyspepsia, anemia, etc. Thus, all said above makes tumors of cardioesophageal zone a rather actual problem. In this article, on an example of patient K., of 61 years of age, possibilities of a complex approach to diagnosis and treatment of a complicated case of cardioesophageal carcinoid are shown.

Conclusion. Diagnosis of carcinoid tumors is difficult and requires a multidisciplinary  approach. The algorithm of diagnostic search and treatment tactics should suggest an individual approach in each clinical case which permits to make a correct diagnosis and to successfully reali-ze a required complex of medical measures.

About the authors

Svetlana S. Kazakova

Ryazan State Medical University

Author for correspondence.
Email: kz-swetlana@yandex.ru
ORCID iD: 0000-0002-8760-2527
SPIN-code: 2234-3604

Candidate of Medical Sciences, associate Professor of the Department of Phthisiology with the course of radiology

Russian Federation,  390026, Ryazan, Vysokovoltnaja, 9

Elena V. Aftaeva

Ryazan State Medical University

Email: aftaeva.elena@gmail.com
ORCID iD: 0000-0003-4418-2259

Assistant of the department of faculty therapy with the course of therapy FDPO

Russian Federation, 390026, Ryazan, Vysokovoltnaja, 9

Elena A. Kurkova

Ryazan State Medical University

Email: lenolium_11@mail.ru
ORCID iD: 0000-0003-3674-4303

Ordinator of the Department of Phthisiology with the course of radiology

Russian Federation, 390026, Ryazan, Vysokovoltnaja, 9

References

  1. References
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  3. Aliev AR, Zeinalov RS, Agalarov ISh. The results of surgical treatment of proximal gastric cancer. Modern Technologies in Medicine. 2011;(1):92-94. (In Russ).
  4. Kovalenko TV, Budzinskiy AA, Melchenko DS. Gastric carcinoid – modern approaches to diagnosis and treatment. Experimental and Clinical Gastroenterology. 2011;(10):95-102. (In Russ).
  5. Chissov VI, Vashakmadze LA, Sidorov DV, et al. Rak proksimal’nogo otdela zheludka: sovremen-nyye podkhody k diagnostike i lecheniyu. Vestnik Rossiyskogo onkologicheskogo nauchnogo tsentra im. N.N. Blokhina RAMN. 2003;14(1):91-5. (In Russ).
  6. Danilova IA. Morphological features of the parenchymal compartment of basic histological forms of gastric carcinoma. I.P. Pavlov Russian Medical Biological Herald. 2011;19(1):8-13. (In Russ).
  7. Perfil’yev IB, Ungiadze GV, Kuvshinov YuP, et al. Evolyutsiya podkhodov k endoskopicheskoy diag-nostike kartsinoidov zheludka. Siberian Oncological Journal. 2010;(S2):37-8. (In Russ).
  8. Karpov DV, Kaminsky YuD, Grigorjev AV, et al. Forecast factors and their influence on results of treatment cancer of the gullet. Nauka Molodykh (Eruditio Juvenium). 2013;(2):39-52.

Supplementary files

Supplementary Files
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2. Fig. 1. Radiographic contrast study of the esophagus and stomach: In the abdominal part of the esophagus and in the cardial part of the stomach a defect of filling is determined 4 x 3 cm with irregular edges, mucosal folds in the zone are not observed.  Against the background gas bubble of the stomach the shadow of the tumorous formation is  visualized. The fasting stomach contains insignificant amount of fluid and mucus.  Emptying of the contrast substance from the stomach is not disturbed.  The bulb and other parts of the duodenum are without changes

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3. Fig. 2. Results of MRT of the abdominal cavity: Thickening of the gastric wall in the zone of the cardial part (attributable to the neoplastic process with infiltrative growth); near the stomach along the right contour enlarged lymph nodes are determined (right cardiodiaphragmal, of lesser curvature, of the left gastric artery) up to 25x17 mm in size. Conclusion: a picture of voluminous formation in the cardial part of the stomach, regional lymphadenopathy (of metastatic character)

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4. Fig. 3. Radiographic contrast examination of the esophagus and stomach in 4 months after surgery

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Copyright (c) 2020 Kazakova S.S., Aftaeva E.V., Kurkova E.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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