Theme |
Gastroenteropancreatic Neuroendocrine Tumors |
Title |
Functioning Pancreatic Neuroendocrine Tumors |
Author |
Chikashi Shibata |
Department of Surgery, Tohoku University Graduate School of Medicine |
Author |
Koh Miura |
Department of Surgery, Tohoku University Graduate School of Medicine |
Author |
Takeshi Naitoh |
Department of Surgery, Tohoku University Graduate School of Medicine |
Author |
Fuyuhiko Motoi |
Department of Surgery, Tohoku University Graduate School of Medicine |
Author |
Takanori Morikawa |
Department of Surgery, Tohoku University Graduate School of Medicine |
Author |
Michiaki Unno |
Department of Surgery, Tohoku University Graduate School of Medicine |
[ Summary ] |
Pancreatic neuroendocrine tumors, other than insulinoma and gastrinoma, include glucagonoma, VIPoma, somatostatinoma, GRFoma, and ACTHoma. All these tumors present symptoms relating to excess secretion of hormones produced by the tumor. Diagnosis is made based on increased plasma concentrations of specific hormones, detection of tumors with imaging modalities including CT, MRI, and EUS, and histopathological examination. Rates of malignancy are generally high, and liver or lymph node metastasis is often observed when the diagnosis is made. We should treat all patients as having malignant tumors and cure the primary tumor with resection and lymph node dissection. Resection should be considered even if the patient exhibits metastasization.Unless curative resection is feasible, the patient should undergo chemotherapy and hormonal therapy.Debulking surgery is performed when it is difficult to control symptoms arising from excess secretion of hormones produced by the tumor. |