Neuroendocrine Tumors of the Gastro-Entero-Pancreatic System: The Role of Early Diagnosis, Genetic Testing and Preventive Surgery

Plöckinger, Ursula; Wiedenmann, Bertram

doi:10.1159/000063164

Cited by 31 publications

(37 citation statements)

References 94 publications

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“…[6][7][8][9][10][11][12][13][14]35 In these patients, gastrinomas are located either in the pancreas or the duodenum (Fig. 6), and recently the duodenal gastrinoma has been reported more frequently than the pancreatic type.…”

Section: Surgery For Gastrinomas In Patients Without Men-1 (Sporadic mentioning

confidence: 99%

“…6 Any suspected duodenal tumors are enucleated and the specimens are sent to the pathologist for diagnostic confirmation of endocrine tumor. [7][8][9][10][11][12][13] After the resection, curability should be confirmed with the IOS test. 35 For patients treated between 1981 and 1988 in whom no tumor was identified with these procedures in spite of localization with the SASI test, we performed PD.…”

Section: When the Sasi Test Localizes Gastrinomas In The Head Of The mentioning

confidence: 99%

“…In the most recent reports, duodenal gastrioma is reported more frequently than pancreatic gastrinoma. [2][3][4][5][6][7][8][9][10][11][12] In patients with ZES and MEN-1, gastrinoma is located mostly in the duodenum, although there are numerous endocrine tumors in the pancreas. In about a half of these patients, multiple duodenal gastrinomas are diffusely located in the duodenum and sometimes they are numerous.…”

mentioning

confidence: 99%

“…[19][20][21][22][23][24][25][26][27] The incidence of hepatic metastases has been reported to be more than 60% in patients with the pancreatic gastrinoma, although it has consistently been less than 10% in patients with duodenal gastrinoma. 11,[22][23][24][25][26][27] Liver metastases are a significant prognostic factor in patients with gastrinoma. Therefore accomplishing a curative resection before liver metastases can develop is Correspondence to: Masayuki Imamura, MD,…”

mentioning

confidence: 99%

“…Symptoms of ZES, such as persistent peptic ulcer, regurgitation esophagitis, or diarrhea, appear even when the gastrinoma is too small to be recognized with computed tomography (CT) or magnetic resonance imaging (MRI), [1][2][3][4][5][6][7][8][9][10][11][12] and localization of small functioning gastropancreatic-endocrine tumors (GEPET) has been unsuccessful. [1][2][3][4] All gastrinomas are potentially metastatic.…”

mentioning

confidence: 99%

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Changing Treatment Strategy for Gastrinoma in Patients with Zollinger‐Ellison Syndrome

Imamura

Komoto²,

Ota³

2005

World j. surg.

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We overviewed the recent development of curative surgery for gastrinoma that has been rapidly improved since the development of new localization techniques, especially the selective arterial secretagogue injection test (SASI test) and somatostatin receptor scintigraphy (SRS). A number of new pathological findings of gastrinomas in patients with Zollinger-Ellison syndrome have been accumulated in accordance with the increase of curative resection of gastrinomas, and these new findings also have contributed to the progress of the treatment strategy for grastrinomas.U ntil recently, medical treatment with a proton pump inhibitor or an H2 blocker has been the treatment of choice for patients with Zollinger-Ellison syndrome (ZES) because of the difficulty in accomplishing curative resection of gastrinomas, which are often metastatic and multiple. Symptoms of ZES, such as persistent peptic ulcer, regurgitation esophagitis, or diarrhea, appear even when the gastrinoma is too small to be recognized with computed tomography (CT) or magnetic resonance imaging (MRI), 1-12 and localization of small functioning gastropancreatic-endocrine tumors (GEPET) has been unsuccessful. [1][2][3][4] All gastrinomas are potentially metastatic. Liver metastases are the significant prognostic factor in patients with gastrinoma, and only R0 resection can achieve a disease-free survival. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] For all of these reasons, curative resection of gastrinomas guided by an accurate localization technique has long been awaited. Such a technique has been realized with the development of the selective arterial secretagogue injection test (SASI test) with secretin or calcium and somatostatin receptor scintigraphy (SRS). 2-6,14-17 Increased curative resection surgery for gastrinomas in patients with ZES has elucidated several important findings.In patients with ZES without multiple endocrine neoplasia type 1 (MEN-1), gastrinoma is located in either the duodenum or the pancreas. In either location, gastrinomas are often single, but occasionally they co-exist. In the most recent reports, duodenal gastrioma is reported more frequently than pancreatic gastrinoma. [2][3][4][5][6][7][8][9][10][11][12] In patients with ZES and MEN-1, gastrinoma is located mostly in the duodenum, although there are numerous endocrine tumors in the pancreas. In about a half of these patients, multiple duodenal gastrinomas are diffusely located in the duodenum and sometimes they are numerous. 6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Incidence of lymph node metastases in patients with either duodenal or pancreatic gastrinomas has been reported to be greater than 40%. [19][20][21][22][23][24][25][26][27] The incidence of hepatic metastases has been reported to be more than 60% in patients with the pancreatic gastrinoma, although it has consistently been less than 10% in patients with duodenal gastrinoma. 11,[22][23][24][25][26][27] Liver metastases are a significant prognostic factor in patients with...

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