Pancreatic endocrine tumors or apudomas

Varas, Modesto; Gornals, Joan B.; Ponseti, José M.; Alastrué, Antonio; Durán, Cristina; Llevaria, Carlos; Ballesta, Carlos García; Díez-Caballero, A; Artígas, Vicente

doi:10.4321/s1130-01082011000400003

Cited by 10 publications

(3 citation statements)

References 55 publications

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“…It is notable for elevated gastrin levels together with a pathological radiotracer deposit on octreoscan (2-5), which occurred in our 2 patients. In 20-35 % of cases, it is associated with multiple MEN-1 endocrine neoplasms (1,6).…”

Section: Discussionmentioning

confidence: 99%

Zollinger-Ellison syndrome

Alventosa-Mateu

Ferrer-Barceló

Huguet-Malavés³

et al. 2013

Rev. esp. enferm. dig.

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We have closely read the article entitled "Pancreatic endocrine tumours or apudomas" (1) published in your journal in April of 2011. Zollinger-Ellison syndrome (ZES) is a rare entity that is found amongst the differential diagnosis of pancreatic endocrine tumours. We present two clinical cases of ZES recently diagnosed in our centre. Case reportsCase report 1. This is a 50-year-old female with an 11-year history of epigastralgia and diarrhoea that only improved with proton pump inhibitors (PPIs) with a return of symptoms within days of suspending the medication. The patient was sent for gastroscopy which revealed duodenal erosions (Helicobacter pylori negative). A complete laboratory workup for diarrhoea was ordered, including gastrin levels, which were greater than 1,000 pg/ml (normal value: 0-90 pg/ml) with the patient off PPIs for 1 week. Remaining laboratory tests were normal. Given these results, gastric pH was tested, revealing a value of 1.9. The study was completed with an endoscopic ultrasound (EUS) which was normal. Somatostatin receptor scintigraphy revealed a pathological radiotracer deposit on the lesser curvature of the stomach (Fig. 1A).

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Section: Discussionmentioning

confidence: 99%

Zollinger-Ellison syndrome

Alventosa-Mateu

Ferrer-Barceló

Huguet-Malavés³

et al. 2013

Rev. esp. enferm. dig.

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“…2)] is an orally active mTOR inhibitor that has been shown to have anti-growth effects in a number of studies involving pNETs [170, 175, 176], including a recent large, placebo-controlled, double-blind trial [RADIANT-3 (RAD001 In Advanced Neuroendocrine Tumors, Novaritis AG, Basel, Switzerland) trial] [17]. In this latter study [17], 410 patients with advanced, progressive pNETs were treated with everolimus (10 mg/day) or placebo, and everolimus demonstrated a significant improvement in progression-free survival (11 vs. 4.6 months, p < 0.0001) and increased by a factor of 3.7 the proportion of patients with progression-free survival at 18 months (37 vs. 9 % with placebo).…”

Section: Introductionmentioning

confidence: 99%

Therapy of metastatic pancreatic neuroendocrine tumors (pNETs): recent insights and advances

2012

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Neuroendocrine tumors (NETs) [carcinoids, pancreatic neuroendocrine tumors (pNETs)] are becoming an increasing clinical problem because not only are they increasing in frequency, but they can frequently present with advanced disease that requires diagnostic and treatment approaches different from those used in the neoplasms that most physicians are used to seeing and treating. In the past few years there have been numerous advances in all aspects of NETs including: an understanding of their unique pathogenesis; specific classification systems developed which have prognostic value; novel methods of tumor localization developed; and novel treatment approaches described. In patients with advanced metastatic disease these include the use of newer chemotherapeutic approaches, an increased understanding of the role of surgery and cytoreductive methods, the development of methods for targeted delivery of cytotoxic agents, and the development of targeted medical therapies (everolimus, sunitinib) based on an increased understanding of the disease biology. Although pNETs and gastrointestinal NETs share many features, recent studies show they differ in pathogenesis and in many aspects of diagnosis and treatment, including their responsiveness to different therapies. Because of limited space, this review will be limited to the advances made in the management and treatment of patients with advanced metastatic pNETs over the past 5 years.

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“…PET-CT may be a match for Octreoscan (31) for tumors other than insulinomas, and only PET-CT is superior to Octreoscan when tumors with a high Ki-67 proliferation index are considered (32), with sensitivity approaching 100% when it comes to finding a primary tumor and its related metastases (35)(36)(37)(38).…”

Section: Introductionmentioning

confidence: 99%