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Recent standardization of treatment strategy for pancreatic neuroendocrine tumors

World Journal of Gastroenterology 2010年第36期16卷 4519-4525页

作者： Masayuki Imamura Department of Surgey Kansai Denryoku Hospital2-1-7FukushimaFukushima-KuOsaka 553-0003Japan

Recent advances in localization techniques,such as the selective arterial secretagogue injection test(SASI test) and somatostatin receptor scintigraphy have promoted curative resection surgery for patients with pancreatic neuroendocrine tumors(PNET).For patients with sporadic functioning PNET,curative resection surgery has been established by localization with the SASI test using secretin or calcium.For curative resection of functioning PNET associated with multiple endocrine neoplasia type 1(MEN 1) which are usually multiple and sometimes numerous,resection surgery of the pancreas and/or the duodenum has to be performed based on localization by the SASI test.As resection surgery of PNET has increased,several important pathological features of PNET have been revealed.For example,in patients with Zollinger-Ellison syndrome(ZES),duodenal gastrinoma has been detected more frequently than pancreatic gastrinoma,and in patients with MEN 1 and ZES,gastrinomas have been located mostly in the duodenum,and pancreatic gastrinoma has been found to co-exist in 13% of patients.Nonfunctioning PNET in patients with MEN 1 becomes metastatic to the liver when it is more than 1 cm in diameter and should be resected after careful observation.The most important prognos-tic factor in patients with PNET is the development of hepatic metastases.The treatment strategy for hepatic metastases of PNET has not been established and aggressive resection with chemotherapy and trans-arterial chemoembolization have been performed with significant benefit.The usefulness of octreotide treatment and other molecular targeting agents are currently being assessed.

关键词： Gastrinoma glucagonoma Insulinoma Multiple endocrine neoplasia type 1 Octreotide Pancreas preserving total duodenectomy Pancreatic neuroendocrine tumors Selective arterial secretagogue injection test Somatostatin receptor scintigraphy

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Solitary concomitant endocrine tumor and ductal adenocarcinoma of pancreas

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World Journal of Gastroenterology 2010年第21期16卷 2692-2697页

作者： Shih-Tang Yan Chang-Kuo Wei Chih-Wen Lin Chih-En Tseng Department of Endocrinology and Metabolism Buddhist Dalin Tzu Chi General HospitalChiayi 622TaiwanChina Department of General Surgery Buddhist Dalin Tzu Chi General HospitalChiayi 622TaiwanChina Department of Medical Imaging Buddhist Dalin Tzu Chi General HospitalChiayi 622TaiwanChina Department of Anatomic Pathology Buddhist Dalin Tzu Chi General HospitalChiayi 622TaiwanChina School of Medicine Tzu Chi UniversityHualien 97004TaiwanChina

Pancreatic tumors with combined exocrine and endocrine features are rare.Most reported cases are classified as mixed exocrine and endocrine carcinoma of the pancreas.We report the first case of solitary concomitant endocrine tumor and ductal adenocarcinoma of the pancreas.A 58-year-old patient was admitted for uncontrolled diabetes mellitus and body weight loss.The tumor was fortuitously discovered in the pancreatic tail after a tumor survey panel.Grossly,the solitary tumor had a central fibrous band that clearly divided it into two parts.On microscopic examination,the tumor contained both endocrine and exocrine components distinctly separated by the central fibrous band.The exocrine part showed a poorly-differentiated adenocarcinoma.The endocrine part was strongly immunoreactive to chromogranin,synaptophysin and glucagon.We reviewed the literature on pancreatic tumors with combined exocrine and endocrine features.A simple classification for this group of neoplasms is suggested,including five types:amphicrine,mixed,collision,solitary concomitant and multiple concomitant.

关键词： Pancreas Concomitant tumor Collision tumor Mixed tumor glucagonoma

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Octreotide acetate long-acting release in treatment of pancreatic neuroendocrine tumors

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Chinese Medical Journal 2009年第13期122卷 1582-1584页

作者： ZHANG Shi LI Yu-xiu LI Nai-shi LI Wen-hui ZHU Hui-juan GU Feng WANG Heng Department of Endocrinology Key Laboratory of Endocrinology Ministry of Health Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100730 China

Pancreatic neuroendocrine tumours are uncommon neoplasms of the pancreas, accounting for around 2% of all primary pancreatic tumors. This specific group of tumours includes insulinoma, gastrinoma, glucagonoma, VIPoma, somatostatinoma and others. They may cause a clinical syndrome due to hormone overproduction. These tumours tend to be less aggressive than pancreatic adenocarcinoma, however, more than 50% of them have metastasized to the liver at the time of diagnosis. Under this circumstance, surgery is impossible to resect all metastases. Thus other various medical measures have been explored in the treatment of these tumors.

关键词： pancreatic neuroendocrine tumours glucagonoma gastrinoma octreotide acetate

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在周期性的 glucagonoma 的骨头损害: 一份案例报告和文学的评论

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World Journal of Gastrointestinal Oncology 2012年第6期4卷 152-155页

作者： Cristian Ghetie Daniel Cornfeld Vassilios S Ramfidis Kostas N Syrigos Muhammad W Saif Danbury Hospital Danbury CT 06810 United States Department of Diagnostic Radiology Yale School of Medicine New Haven CT 06510 United States Third Department of Medicine Sotiria General Hospital Athens Medical School Athens 11527 Greece Section of Medical Oncology Yale School of Medicine New Haven CT 06510 United States Division of Hematology and Oncology Department of Medicine Columbia University NY 10032 United States

glucagonomas are rare neuroendocrine tumors that arise from cells of the pancreatic islets. Most of them are malignant and usually present as metastatic disease. Sites most commonly involved in metastases are the liver and regional lymph nodes. Bone metastases are rare events and only a few cases have been reported in the literature. We present the case of a 53-year-old male with a medical history of recurrent non-functioning glucagonoma. He presented 17 years after the initial diagnosis with new blastic bone lesions involving the T1 vertebra and the sacrum. Diagnostic steps and medical management in metastatic glucagonoma are also reviewed.

关键词： glucagonoma Bone metastases Blastic lesion Octreoscan

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