Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances

Best Pract Res Clin Gastroenterol. 2012 Dec;26(6):737-53. doi: 10.1016/j.bpg.2012.12.003.

Abstract

Pancreatic neuroendocrine tumors (pNETs) comprise with gastrointestinal carcinoids, the main groups of gastrointestinal neuroendocrine tumors (GI-NETs). Although these two groups of GI-NETs share many features including histological aspects; over-/ectopic expression of somatostatin receptors; the ability to ectopically secrete hormones/peptides/amines which can result in distinct functional syndromes; similar approaches used for tumor localization and some aspects of treatment, it is now generally agreed they should be considered separate. They differ in their pathogenesis, hormonal syndromes produced, many aspects of biological behaviour and most important, in their response to certain anti-tumour treatment (chemotherapy, molecular targeted therapies). In this chapter the clinical features of the different types of pNETs will be considered as well as aspects of their diagnosis and medical treatment of the hormone-excess state. Emphasis will be on controversial areas or recent advances. The other aspects of the management of these tumors (surgery, treatment of advanced disease, tumor localization) are not dealt with here, because they are covered in other chapters in this volume.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Gastrointestinal Neoplasms / diagnosis
  • Gastrointestinal Neoplasms / metabolism
  • Gastrointestinal Neoplasms / therapy
  • Glucagonoma / diagnosis
  • Glucagonoma / therapy
  • Humans
  • Insulinoma / diagnosis
  • Insulinoma / therapy
  • Molecular Targeted Therapy
  • Neuroendocrine Tumors* / diagnosis
  • Neuroendocrine Tumors* / genetics
  • Neuroendocrine Tumors* / metabolism
  • Neuroendocrine Tumors* / therapy
  • Pancreatic Neoplasms* / diagnosis
  • Pancreatic Neoplasms* / genetics
  • Pancreatic Neoplasms* / metabolism
  • Pancreatic Neoplasms* / therapy
  • Receptors, Somatostatin / classification
  • Receptors, Somatostatin / therapeutic use
  • Somatostatinoma / diagnosis
  • Somatostatinoma / therapy
  • Vipoma / diagnosis
  • Vipoma / therapy
  • Zollinger-Ellison Syndrome / diagnosis
  • Zollinger-Ellison Syndrome / therapy

Substances

  • Receptors, Somatostatin