Management of non-functioning neuroendocrine tumours of the pancreas

Abstract

Between 1982 and 1991, 20 patients of median age 44 (range 22-76) years were treated for non-functioning neuroendocrine tumours of the pancreas. Presenting features were obstructive jaundice (seven patients), abdominal pain (seven), weight loss (six), abdominal mass (eight) and severe haemorrhage (four). Gut hormone profiles were normal except for one patient who had a raised pancreatic polypeptide level. Contrast-enhanced computed tomography localized the tumour in 17 patients and visceral angiography in 14 of 15; all but three tumours were highly vascular. Ten patients underwent curative resection, and the remainder were managed palliatively by resection (four), bypass procedures (three) or biopsy alone (three). There were two postoperative deaths and seven early complications. Seven of the remaining 18 patients have died from disease a median of 16 (range 4-30) months after presentation. The 11 survivors, eight of whom had curative resections, have been followed for a median of 42 (range 7-72) months. Ten patients are asymptomatic but only five are free from disease. These tumours are seldom curable by radical surgery, but patients may remain free from symptoms for many years.

Well-Differentiated Pancreatic Nonfunctioning Tumors/Carcinoma

“…Abdominal pain is the major presenting symptom (35–78%), followed by weight loss (20–35%), anorexia and nausea (45%). The patient may present with intra-abdominal hemorrhage (4–20%), jaundice (17–50%) or a palpable mass (7–40%) [21,22,23,24,25]. Fifty-nine percent to 80% of the patients present with synchronous liver metastases at diagnosis [10, 25].…”

Nowotwory neuroendokrynne trzustki — zasady postępowania (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

“…The most common symptoms include: abdominal pain (35-78%), weight loss (20-35%), loss of appetite and vomiting (45%). Less common are internal haemorrhages (4-20%), jaundice (17-50%) or palpable tumours in the abdomen (7-40%) [2,[24][25][26]. Recent studies by Italian researchers have demonstrated that hepatic metastases are observed in 32% of patients with a newly diagnosed NF-PNEN [27].…”

Duodenal Leiomyosarcoma

“…The common cystic appearance on CT is explained by central necrosis of these slow-growing tumours. They can be vascular lesions which blush on angiography and mimic nonfunctioning neuroendocrine tumours of the pancreas [12]. They tend to ulcerate into the small bowel causing either iron-deficiency anaemia or frank gastrointestinal haemorrhage.…”