Clinical Image - Volume 2 - Issue 2

Particular endoscopic presentation of multiple gastric ECLomas

Mouna Tamzaourte* ; Imane Mouslim; Sanae Berrag; Tarik Adioui

Department of Gastroenterology I, Mohammed V Military Hospital, Faculty of Medicine and Pharmacy of Rabat, Morocco.

Received Date : Apr 15, 2022
Accepted Date : May 30, 2022
Published Date: Jun 14, 2022
Copyright:© Mouna Tamzaourte 2022

*Corresponding Author : Mouna Tamzaourte, Department of gastroenterology 1, Military Hospital Mohammed V, Hay Ryad BP 10100 Rabat Morocco. Tel: 00212 661 490807.

Clinical-medical image

66-year-old woman with no significant pathological history is admitted for etiologic assessment of anemia. It is an iron deficiency microcytic anemia with hemoglobin at 9.8g/dL. An upper digestive endoscopy showed multiple fundic polypoid lesions of variable size measuring more than 10mm, including a subcardial lesion measuring 20mm (Figure 1&2). With the presence of other antrals centimetrics polypoids lesions. The anatomopathological examination of the lesions is in favor of ECL (enterochromaffin like) cell carcinoids. Fundic biopsy revealed fundic atrophy consistent with Biermer's disease. The biological assessment showed a collapsed vitamin B12 level with the presence of anti parietal cell antibodies. The treatment is based on injectable iron infusions, vitamin B12 injections and taking proton pump inhibitors. supracentimetric polypoid lesions were resected endoscopically with regular endoscopic control of other small lesions. Gastric neuroendocrine tumors form a heterogeneous group, very largely dominated by tumors derived from so-called enterochromaffin-like (ECL) cells, endocrine cells specialized in the secretion of histamine and located within the fundic mucosa, at the deep part of the glands [1]. The vast majority of ECL cell tumors occur in a context of hypergastrinemia. It is most often a hypergastrinemia secondary to achlorhydria induced by chronic atrophic gastritis affecting the fundic mucosa (especially in the context of Biermer's disease). Endoscopically, gastric neuroendocrine tumors appear as multiple small polypoid lesions of less than 1 cm in size. Therapeutically, simple monitoring is recommended for ECLomas < 1 cm in size. In case of size > 1 cm, an endoscopic mucosectomy is sufficient if the submucosa is undamaged. Otherwise, ECLomas are treated by local resection associated with antrectomy.

Keywords: ECLoma; gastric neuroendocrine tumors; biermer’s disease; hypergastrinemia.

Figure 1 and 2: An upper digestive endoscopy showed multiple fundic polypoid lesions of variable size measuring more than 10mm, including a subcardial lesion measuring 20mm.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.


  1. Delle Fave G, Capurso G, Milione M, Panzuto F. Endocrine tumours of the stomach. Best Pract Res Clin Gastroenterol. 2005 Oct; 19(5): 659-73. [PMID: 16253892 DOI: 10.1016/j.bpg.2005.05.002].
  2. Ruszniewski P, Delle Fave G, Cadiot G, Komminoth P, Chung D, Kos-Kudla B, Kianmanesh R, et al. Frascati Consensus Conference; European neuroendocrine Tumor Society. Well-differentiated gastric tumors/carcinomas. Neuroendocrinology. 2006; 84(3): 158-64. [PMID: 17312375 DOI: 10.1159/000098007] [Epub 2007 Feb 20].