Diagnosis and management of type III gastric neuroendocrine tumor: Recent advances

Gastric Neuroendocrine Tumors (NETs) encompass a heterogeneous group of neoplasms arising from enterochromaffin-like cells in the gastric mucosa. Among the various subtypes, type III gastric NETs represent a clinically and biologically distinct entity characterized by their aggressive behavior and unique histopathological features. This review aims to provide an overview and update on diagnosis and management of type III gastric NETs. In general, type III gastric NETs present diagnostic and therapeutic challenges due to their nonspecific clinical manifestations and heterogeneous biological behavior. Advances in diagnostic modalities, including endoscopic techniques, and molecular profiling, have improved our understanding of the pathogenesis and classification of type III gastric NETs, facilitating more accurate diagnosis and risk stratification. Treatment strategies for type III gastric NETs encompass a multimodal approach, including endoscopic/surgical resection, medical therapy, peptide receptor radionuclide therapy, and chemotherapy, tailored to the individual patient’s tumor characteristics and stage of disease. Endoscopic resection has emerged as a valuable therapeutic option for select cases of well-differentiated lesions confined to the mucosal or submucosal layers, offering the advantages of minimal invasiveness and preservation of gastric function.