Diagnosis of functioning pancreaticoduodenal neuroendocrine tumors

Imamura, Masayuki; Nakamoto, Yuji; Uose, Suguru; Komoto, Izumi; Awane, Masaaki; Taki, Yoshiro

doi:10.1002/jhbp.209

Cited by 16 publications

(16 citation statements)

References 52 publications

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“…However, hypergastrinemia may also be observed in patients with atrophic gastritis or gastric outlet obstruction. Thus, analysis of gastric acid secretion should be applied for the differential diagnosis of gastrinoma (28). The patient in the present case exhibited normal PTH and blood calcium levels, and was subsequently diagnosed with SG.…”

Section: Discussionmentioning

confidence: 71%

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Clinical treatment of gastrinoma: A case report and review of the literature

et al. 2016

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Abstract. Gastrinoma is a gastrin-secreting tumor that is associated with Zollinger-Ellison syndrome. The majority of cases occur in the pancreas, followed by the duodenum. Early diagnosis is difficult due to the relative rarity of the tumor and the lack of specific symptoms. In the current study, a 68-year-old female patient presented at the Second Affiliated Hospital, Zhejiang University (Hangzhou, China) due to intermittent abdominal pain and watery diarrhea. The patient was treated by surgical resection and was pathologically diagnosed with a well-differentiated pancreatic neuroendocrine tumor (gastrinoma; grade 1). No evidence of recurrence was observed during 1 year of follow-up. Furthermore, a review of the Chinese literature was performed, which analyzed an additional 17 published cases of gastrinoma. The tumor size ranged between 0.5x0.5 cm and 7.5x6.3x5.1 cm. The pancreas was the most common site of occurrence, accounting for 72% (13/18) of cases, followed by the duodenum (28%; 5/18). The most common initial symptom was abdominal pain (89%; 16/18), followed by diarrhea (56%; 10/18). In 18 cases, including the present case and 17 previous cases, the level of gastrin ranged between 137 and 1,550 pg/ml (normal range, 5-100 pg/ml). Of the 17 previous cases, 11 patients underwent surgery and 6 patients received conservative therapy due to metastasis or patient choice. Overall, gastrinoma remains a rare disease. Complete removal of the lesion is the standard curative treatment and conservative treatment is only recommended for patients unsuitable for surgery or for those with widespread metastasis.

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Section: Discussionmentioning

confidence: 71%

“…The common clinical manifestations of gastrinoma include abdominal pain, secretory diarrhea, esophagitis and hypercalcemia (28). Abdominal pain is the most common presentation and is usually caused by peptic ulcers (4).…”

Section: Discussionmentioning

confidence: 99%

Clinical treatment of gastrinoma: A case report and review of the literature

et al. 2016

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“…Insulinoma is a rare neuroendocrine tumor that produces excess endogenous insulin, resulting in hypoglycemia [4]. As previously shown, hypoglycemia unawareness is not rare in patients with insulinoma, and it can obscure a patient's notice of hypoglycemia [3].…”

Section: Discussionmentioning

confidence: 99%

“…remains a clinical issue [4]. One of the main causes of delay is hypoglycemia unawareness, which can obscure a patient's notice of hypoglycemia and worsen the outcomes [3][4][5].…”

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confidence: 99%

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Factory-calibrated continuous glucose monitoring and capillary blood glucose monitoring in a case with insulinoma: usefulness and possible pitfall under chronic hyperinsulinemic hypoglycemia

et al. 2020

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The accuracy of factory-calibrated continuous glucose monitoring (fCGM) within hypoglycemic ranges, especially under the status of chronic hyperinsulinemic hypoglycemia like insulinomas, remains an issue. Even so, fCGM is known to be useful for detecting hypoglycemia unawareness in insulinoma cases. A 25-year-old woman presenting with sudden unconsciousness was diagnosed with insulinoma; fCGM facilitated diagnosis by continuous monitoring for hypoglycemia. Before surgery, she was treated with continuous and frequent bolus infusions of 50% glucose via central venous catheter. To evaluate the accuracy of fCGM values in this case, a comparison between fCGM and capillary blood glucose (CBG) values was also performed. According to the simultaneously measured values, those of fCGM were largely in accordance with those of CBG. Moreover, compared with the previously reported case not having glucose infusions via central venous catheter, both the mean absolute relative differences (MARDs) and the absolute differences (Δ glucose) between fCGM and CBG values were larger in the present case, although no significant differences of MARDs and Δ glucose between the two cases were observed in several different conditions including fasting, post-meal, hypoglycemia, and others. Therefore, we should note possible increased differences between fCGM and CBG values in cases using frequent intravenous glucose infusions as well as case-dependent differing levels of consistency between them.

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Highlights of topic “Pancreatic neuroendocrine tumors update”

Ito

2015

J Hepato Biliary Pancreat

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Diagnosis of functioning pancreaticoduodenal neuroendocrine tumors

Cited by 16 publications

References 52 publications

Clinical treatment of gastrinoma: A case report and review of the literature

Clinical treatment of gastrinoma: A case report and review of the literature

Factory-calibrated continuous glucose monitoring and capillary blood glucose monitoring in a case with insulinoma: usefulness and possible pitfall under chronic hyperinsulinemic hypoglycemia

Highlights of topic “Pancreatic neuroendocrine tumors update”

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