Diagnosis and treatment of ECL cell tumors

The diagnosis of ECL-omas is easy to perform. In patients with Zollinger-El lison syndrome (ZES), ECL-omas are almost always observed in the setting of multiple endocrine neoplasia type I. In patients without ZES, the first st ep is to discard non-gastrin-related sporadic ECL-omas whose prognosis is p oor. By contrast, prognosis of ECL-omas in patients with ZES or chronic atr ophic gastritis is good. Metastases are rare, and tumor-related deaths are exceptional. In both conditions, ECL-omas measuring less than 1 cm should b e treated by endoscopic polypectomy and survey. Treatment modalities (surge ry, endoscopic polypectomy) for larger tumors are still discussed. The impa ct of endoscopic ultrasonography on the therapeutic decision has not yet be en evaluated. Considering the good prognosis of these tumors, aggressive su rgery could be limited to selected patients. Multicentric studies should be undertaken to determine the best treatment modalities.