Contemporary issues in the surgical management of pancreatic neuroendocrine tumours

2019 ◽  
Vol 23 (2) ◽  
pp. 37-41
Author(s):  
Jonathan G. Sham ◽  
Michele M. Gage ◽  
Jin He
Keyword(s):  
Surgical Management ◽  
Neuroendocrine Tumours ◽  
Pancreatic Neuroendocrine Tumours

scholarly journals The Impact of Preoperative Endoscopic Ultrasound on the Surgical Management of Pancreatic Neuroendocrine Tumours

2008 ◽  
Vol 22 (10) ◽  
pp. 817-820 ◽  
Author(s):  
Fahad Alsohaibani ◽  
David Bigam ◽  
Norman Kneteman ◽  
AM James Shapiro ◽  
Gurpal Singh Sandha
Keyword(s):  
Surgical Management ◽  
Endoscopic Ultrasound ◽  
Neuroendocrine Tumours ◽  
Preoperative Assessment ◽  
Needle Aspiration ◽  
Ct Scanner ◽  
Extent Of Surgery ◽  
Pancreatic Neuroendocrine Tumours ◽  
Needle Aspiration Cytology ◽  
The Impact

BACKGROUND: Endoscopic ultrasound (EUS) is accurate in diagnosing pancreatic neuroendocrine tumours (PNETs), but its impact on surgical management is unclear.OBJECTIVE: To determine whether preoperative EUS findings altered the decision for, and extent of, surgery in patients with PNETs.METHODS: A retrospective review of patients referred for EUS because of suspected PNETs was conducted. The diagnosis of PNETs was confirmed by EUS-guided fine needle aspiration cytology, where indicated, or by surgical histology. EUS findings were compared with computed tomography (CT) findings to determine whether there was an impact on the decision for surgical management.RESULTS: Fourteen patients (10 women), with a mean age of 44 years, underwent EUS for suspected PNETs. PNETs were seen with CT in 10 of 13 patients (77%) and with EUS in 14 of 14 patients (100%). One obese patient could not fit into the CT scanner. This patient had five PNETs on EUS. Three patients with a normal CT scan were determined to have one or two PNETs on EUS. Three patients with one or two PNETs on CT were found to have five to eight PNETs on EUS. EUS altered the decision for possible surgical management in five of 14 patients (36%), either by identifying a PNET or by finding multiple and multifocal PNETs that were not visualized on CT scans.CONCLUSION: EUS is useful in the preoperative assessment of PNETs by providing information that significantly influences the decision for surgical intervention or changes the extent of the planned surgery.

Rare case of pancreatic neuroendocrine tumour presenting as paraneoplastic hypercalcaemia

2021 ◽  
Vol 14 (4) ◽  
pp. e240786
Author(s):  
Benjamin Ferrel ◽  
Jan Franko ◽  
May C Tee
Keyword(s):  
Parathyroid Hormone ◽  
Surgical Management ◽  
Rare Case ◽  
Neuroendocrine Tumours ◽  
Neuroendocrine Tumour ◽  
Related Peptide ◽  
Pancreatic Neuroendocrine Tumours ◽  
Successful Removal ◽  
Pancreatic Neuroendocrine Tumour ◽  
Parathyroid Hormone Related Peptide

An asymptomatic 68-year-old woman who presented with an isolated hypercalcaemia was diagnosed with a rare, previously unsuspected parathyroid hormone-related peptide (PTHrP)-producing pancreatic neuroendocrine tumour. She underwent an extensive operation including vascular resection and reconstruction, resulting in successful removal of the tumour with negative margins. Medical and surgical management of pancreatic neuroendocrine tumours and PTHrP-mediated paraneoplastic hypercalcaemia is discussed.

scholarly journals Surgical management of gastro-entero-pancreatic neuroendocrine tumours

2011 ◽  
Vol 4 ◽  
pp. 252-258
Author(s):  
Piotr Arkuszewski ◽  
Zbigniew Pasieka ◽  
Krzysztof Kołomecki ◽  
Jacek Śmigielski ◽  
Michał Kusiński ◽  
...  
Keyword(s):  
Surgical Management ◽  
Neuroendocrine Tumours ◽  
Pancreatic Neuroendocrine Tumours

scholarly journals Updated Principles of Surgical Management of Pancreatic Neuroendocrine Tumours (pNETs): What Every Surgeon Needs to Know

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 5969
Author(s):  
Charles de Ponthaud ◽  
Fabrice Menegaux ◽  
Sébastien Gaujoux
Keyword(s):  
Surgical Management ◽  
Neuroendocrine Tumours ◽  
Pancreatic Neoplasm ◽  
Distant Metastases ◽  
High Volume ◽  
Invasive Approach ◽  
Pancreatic Tumour ◽  
Functional Consequences ◽  
Pancreatic Neuroendocrine Tumours ◽  
Selection Of

Pancreatic neuroendocrine tumours (pNETs) represent 1 to 2% of all pancreatic neoplasm with an increasing incidence. They have a varied clinical, biological and radiological presentation, depending on whether they are sporadic or genetic in origin, whether they are functional or non-functional, and whether there is a single or multiple lesions. These pNETs are often diagnosed at an advanced stage with locoregional lymph nodes invasion or distant metastases. In most cases, the gold standard curative treatment is surgical resection of the pancreatic tumour, but the postoperative complications and functional consequences are not negligible. Thus, these patients should be managed in specialised high-volume centres with multidisciplinary discussion involving surgeons, oncologists, radiologists and pathologists. Innovative managements such as “watch and wait” strategies, parenchymal sparing surgery and minimally invasive approach are emerging. The correct use of all these therapeutic options requires a good selection of patients but also a constant update of knowledge. The aim of this work is to update the surgical management of pNETs and to highlight key elements in view of the recent literature.

Algorithm of diagnosis of pancreatic neuroendocrine tumours on fine needle aspiration specimens

2018 ◽  
Author(s):  
Cristiana Popp ◽  
Mirela Daiela Cioplea ◽  
Sabina Zurac ◽  
Patricia-Irina Stinga ◽  
Alexandra Ioana Dragusin ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Neuroendocrine Tumours ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Pancreatic Neuroendocrine Tumours

Imaging of Pancreatic-Neuroendocrine Tumours: An Outline of Conventional Radiological Techniques

2019 ◽  
Vol 12 (2) ◽  
pp. 135-155 ◽  
Author(s):  
Muhammad Affan Zamir ◽  
Wasim Hakim ◽  
Siraj Yusuf ◽  
Robert Thomas
Keyword(s):  
Neuroendocrine Tumours ◽  
Treatment Options ◽  
Advantages And Disadvantages ◽  
Imaging Characteristics ◽  
Fundamental Understanding ◽  
Pancreatic Neuroendocrine Tumours ◽  
Direct Management ◽  
Important Disease ◽  
Similar Imaging

IIntroduction: Pancreatic Neuroendocrine Tumours (p-NETs) are an important disease entity and comprise of peptide-secreting tumours often with a functional syndrome. : Accounting for a small percentage of all pancreatic tumours, they have a good overall survival rate when diagnosed early, with surgery being curative. The role of nuclear medicine in the diagnosis and treatment of these tumours is evident. However, the vast majority of patients will require extensive imaging in the form of conventional radiological techniques. It is important for clinicians to have a fundamental understanding of the p-NET appearances to aid prompt identification and to help direct management through neoplastic staging. Methods: This article will review the advantages and disadvantages of conventional radiological techniques in the context of p-NETs and highlight features that these tumours exhibit. Conclusion: Pancreatic neuroendocrine tumours are a unique collection of neoplasms that have markedly disparate clinical features but similar imaging characteristics. Most p-NETs are small and welldefined with homogenous enhancement following contrast administration, although larger and less welldifferentiated tumours can demonstrate areas of necrosis and cystic architecture with heterogeneous enhancement characteristics. : Prognosis is generally favourable for these tumours with various treatment options available. However, conventional radiological techniques will remain the foundation for the initial diagnosis and staging of these tumours, and a grasp of these modalities is extremely important for physicians.

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