Endoscopic techniques for diagnosis and treatment of gastro-entero-pancreatic neuroendocrine neoplasms: Where we are

Rossi, Roberta; Elvevi, Alessandra; Gallo, Camilla; Palermo, Andrea; Invernizzi, Pietro; Massironi, Sara

doi:10.3748/wjg.v28.i26.3258

Cited by 16 publications

(11 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, endoscopic ultrasound has higher technical requirements for the operator. 20 The consensus guideline proposed by the European Neuroendocrine Tumor Society (ENETS) suggests that endoscopic ultrasonography (EUS) is the first step for evaluation of R-NET. However, according to the guideline proposed by the National Comprehensive Cancer Network (NCCN), EUS is not indispensable for rectal NETs smaller than 1 cm in size.…”

Section: Discussionmentioning

confidence: 99%

Optimization of Endoscopic Submucosal Dissection and Endoscopic Mucosal Resection Strategies for Rectal Neuroendocrine Tumors Within 20 mm

Yu,

Zhang,

et al. 2024

The American Surgeon™

View full text Add to dashboard Cite

Aims No consensus regarding the optimal endoscopic resection approach for rectal neuroendocrine tumors (R-NETs) measuring 10-20 mm, this study aims to investigate this issue. Methods Patients with R-NETs underwent either endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The primary endpoint was the complete resection rate, and the secondary endpoints were surgery-related complications and long-term outcomes. Results 96 patients met the inclusion criteria, 84 patients completed endoscopic resection, and 5 patients were excluded. 79 patients were enrolled and divided into EMR (n = 21) and ESD groups (n = 58). 100% of ESD excisions reached the primary endpoint, while 90.5% of EMR. Endoscopic submucosal dissection can achieve higher R0 rate and lower positive margin rate than EMR. The mean operative time of ESD and EMR was 35.22 ± 8.96 min and 13.14 ± 3.26 min, respectively. The complication rates of ESD and EMR were 3.4% and 4.8%, respectively. For R-NETs between 10 mm and 20 mm, the R0 rate of ESD was significantly higher than that of EMR (100% vs 71.4%, P = .01) and the margin positive rate of ESD was significant lower than that of EMR (4.8% vs 42.9%, P < .05). Both ESD and EMR obtained 100% R0 resection of less than 10 mm R-NET. The median follow-up was 13 months (3-84 months); 1 patient relapsed 25 months after EMR and was re-treated with ESD. Conclusion For R-NETs with a diameter less than 10 mm, both EMR and ESD were safe and effective and EMR is convenient and fast, with advantages. ESD offers superiority for R-NETs between 10 and 20 mm and can be considered as the preferred method.

show abstract

Section: Discussionmentioning

confidence: 99%

Optimization of Endoscopic Submucosal Dissection and Endoscopic Mucosal Resection Strategies for Rectal Neuroendocrine Tumors Within 20 mm

Yu,

Zhang,

et al. 2024

The American Surgeon™

View full text Add to dashboard Cite

show abstract

“…Upper and lower GI endoscopies (standard axial endoscopy) are crucial for the detection, biopsy, and therapeutic resection of GI NETs (stomach, duodenum, rectal, colon). EUS is the diagnostic gold standard for pancreatic NET [ 9 ]. However, due to poor accessibility in the distal small intestine, standard axial endoscopy and EUS often fail to detect the small intestine lesions and delay the diagnosis of SBNET.…”

Section: Discussionmentioning

confidence: 99%

“…Due to its rarity, the data are usually based on small retrospective studies, and limited data on sensitivity and specificity are currently available. Instead, diagnostic yield is often used in studies [ 9 , 10 ]. Capsule endoscopy is a patient-friendly and minimally invasive method for visualizing the entire small bowel.…”

Section: Discussionmentioning

confidence: 99%

“…Capsule retention is considered the major complication in 1.5-2.6% of cases [ 10 ]. Double balloon enteroscopy shows a variable diagnostic yield ranging from 30% to 80%, but a false-positive rate of 17% has been reported [ 9 ]. Due to the lower rate of false positives in capsule endoscopy, it should be the first choice for SBNET endoscopy diagnosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Challenge of Small Bowel Neuroendocrine Tumor in a Young Female Patient

Lee¹,

Jyala²,

Ghazanfar³

et al. 2023

Cureus

View full text Add to dashboard Cite

Neuroendocrine tumors (NETs) are rare cancers arising from neuroendocrine cells and are characterized by their ability to secrete functional hormones causing distinctive hormonal syndromes. The incidence of NET has increased over the years, and small bowel neuroendocrine tumor (SBNET) is one of the most challenging to detect due to its varied presentation and poor accessibility with traditional endoscopic methods. Patients with SBNET present with variable hormonal symptoms, such as diarrhea, flushing, and nonspecific abdominal pain, which often delay the diagnosis. We present the case of a young patient who underwent multidisciplinary workups leading to a successful diagnosis of SBNET promptly. The patient was a 31-year-old female who presented to the emergency department with complaints of nausea, vomiting, and sudden-onset, severe, sharp abdominal pain. CT scan of her abdomen showed an area of irregular intraluminal soft tissue density suspicious for a mass in the mid-small bowel. The patient’s initial enteroscopy was normal. A video capsule endoscopy showed a small bowel mass, which was consistent with SBNET confirmed by pathology later. This case emphasizes the importance of considering SBNET as a differential diagnosis in young patients with nonspecific symptoms of abdominal pain and highlights the role of multidisciplinary approaches in achieving prompt diagnosis and treatment.

show abstract

“…Methods A 59-years-old woman presented with symptomatic hypoglycaemia with increased plasma insulin level (≥6 μU/ml) and increased C peptide level (≥0.2 nmol/l) suggesting an insulinoma. Imaging studies performed to localize the tumor (CT scan, MRI and 68Gallium-PET) were all negative only showing two millimetric cystic lesions in the body of the pancreas and a stone in the tail 1 2 3 4 5 6 7 8 9 10 .…”

mentioning

confidence: 99%

Always look behind the rock: a case of an insulinoma hidden by a pancreatic stone

Andreozzi,

Spadaccini,

Capretti

et al. 2023

ESGE Days 2023

View full text Add to dashboard Cite

Endoscopic techniques for diagnosis and treatment of gastro-entero-pancreatic neuroendocrine neoplasms: Where we are

Cited by 16 publications

References 85 publications

Optimization of Endoscopic Submucosal Dissection and Endoscopic Mucosal Resection Strategies for Rectal Neuroendocrine Tumors Within 20 mm

Optimization of Endoscopic Submucosal Dissection and Endoscopic Mucosal Resection Strategies for Rectal Neuroendocrine Tumors Within 20 mm

Diagnostic Challenge of Small Bowel Neuroendocrine Tumor in a Young Female Patient

Always look behind the rock: a case of an insulinoma hidden by a pancreatic stone

Contact Info

Product

Resources

About