Gastroenteropancreatic Endocrine Tumours: Effects of Octreotide Treatment

Meier, Rémy

doi:10.1159/000172303

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…The surgeon must take into consideration alternative treatment and the possibility of conservative control of symptoms. Diazoxide, phenytoin, and somatostatin analogs can be administered to control hypoglycemia [34,35]. Positive somatostatin receptor imaging may be predictive of treatment success, so it should be employed prior to therapy [36].…”

Section: Discussionmentioning

confidence: 99%

Reoperative Surgery for Organic Hyperinsulinism: Indications and Operative Strategy

et al. 1998

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Organic hyperinsulinism has a good chance of cure by operation, although patients with diffuse or multiple disease run a high risk of recurrence or persistence of disease. Surgical management and outcome in these patients are presented and discussed. Between 1986 and April 1997 a total of 62 patients were operated on for organic hyperinsulinism [solitary 48, multiple 3, multiple endocrine neoplasia type I (MEN-I) 2, diffuse 4, malignant 5]. Persistence or recurrence occurred in 10 patients (16%). Among the six that persisted, four were malignant and two benign. All four of those that recurred were benign. Patients with benign disease presented with multiple tumors (n = 3), MEN-I syndrome (n = 1), and diffuse/nodular hyperplasia (n = 2). The duration between diagnosis and reintervention ranged from 1 to 10 years. Preoperative diagnosis was able to localize tumors in three patients (computed tomography 1, angiography 2, calcium stimulation 1). Operative procedures were multiple enucleations in two patients with sporadic disease, subtotal resection plus enucleation in the case of MEN-I syndrome, subtotal resection for diffuse hyperplasia, left resection for adenomatosis, and tumor extirpation after multiple previous operations. Long-term clinical and biochemical cure was achieved in five of six patients (mean follow-up 5 years). Octreotide therapy shows good symptomatic control in the patient with operative failure. Reintervention for organic hyperinsulinism is successful (80% cure) and requires preoperative imaging and individual surgical management.

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Section: Discussionmentioning

confidence: 99%

Reoperative Surgery for Organic Hyperinsulinism: Indications and Operative Strategy

et al. 1998

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“…Somatostatinanaloga (Oktreotid) haben sich in der Behandlung von neuroendokrinen Tumoren sehr bewä hrt. Dies betrifft jedoch ü berwiegend die Behandlung von Gastrinomen und Carcinoidtumoren [1,13,14]. Ü ber die Therapie von Insulinomen liegen nur Einzelbeschreibungen vor.…”

Section: Konservative Therapieunclassified

Spezielle diagnostische und therapeutische Aspekte beim Insulinom

Röher

Simon

Starke

et al. 1997

Chirurg

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Insulinomas are rare tumors and account for 90% of all endocrine pancreatic tumors. They typically present as a solitary tumor, but may occur in multiple sites (e.g. multiple endocrine neoplasia type I) or as a malignant disease in 10% of cases and rarely as nesidioblastosis or islet cell adenomatosis. Neuroglucopenic symptoms lead to the diagnosis; inadequate high insulin and C-peptide secretion with hypoglycemia in the fasting test confirm the diagnosis. Preoperative localization is not necessary prior to the first operation. The standard operation is enucleation, or depending on size and location, resection. The treatment of multiple tumors and islet cell hyperplasia with a high risk of recurrence is problematic. Subtotal resection plus enucleation seems to be better than selective tumor resection. In malignant insulinomas, mostly presenting with liver metastases, aggressive surgical therapy with hepatectomy and debulking, chemoembolization and systemic chemotherapy are the modalities of choice.

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Functional Analysis of Corporate Rescue Procedures: A Proposal from an Anglo-Swiss Perspective

Brupbacher

2005

Journal of Corporate Law Studies

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Gastroenteropancreatic Endocrine Tumours: Effects of Octreotide Treatment

Cited by 3 publications

References 10 publications

Reoperative Surgery for Organic Hyperinsulinism: Indications and Operative Strategy

Reoperative Surgery for Organic Hyperinsulinism: Indications and Operative Strategy

Spezielle diagnostische und therapeutische Aspekte beim Insulinom

Functional Analysis of Corporate Rescue Procedures: A Proposal from an Anglo-Swiss Perspective

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