Should gastric carcinoid tumors associated with pernicious anemia be treated aggressively?

Two patients with pernicious anemia developed gastric carcinoid, one 20 years and the other 1 year after diagnosis of pernicious anemia. One of the patients underwent successful resection of the tumor, while the second, with diffuse gastric carcinoid, was managed conservatively. She is well and asymptomatic 32 months after the diagnosis. We discuss the dilemma in management of gastric carcinoid associated with pernicious anemia.