American Board of Surgery Qualifying Exam (ABS QE) Practice Test

In which type of gastric carcinoid is aggressive behavior and larger size (>1 cm) most commonly observed?

1. Type 1

2. Type 2

3. Type 3

4. Type 4

The correct answer is: Type 3

Gastric carcinoids, also known as neuroendocrine tumors, are typically classified into four types based on their associated conditions and clinical behavior. Type 3 gastric carcinoids are characterized by their aggressive behavior and are often larger than 1 cm in size. They tend to arise independently and do not have the associated conditions of achlorhydria or hypergastrinemia seen in types 1 and 2, which are more benign and often smaller. Type 3 carcinoids are usually sporadic and can be associated with other neoplasms. They exhibit a higher mitotic rate and a greater tendency to metastasize compared to the other types. In contrast, type 1 and type 2 carcinoids arise in the context of chronic settings that lead to hypergastrinemia, which typically results in smaller, more indolent tumors. Type 4 is very rare and is usually used to describe poorly differentiated gastric neuroendocrine carcinoma, which may not specifically pertain to carcinoids but rather to more aggressive neoplasms. Thus, the characteristics of type 3 gastric carcinoids align perfectly with the described behavior, making them the most relevant in discussions of aggressive tumors with a size greater