The Distal Predilection of Small Bowel Neuroendocrine Tumors

Keck, Kendall J.; Maxwell, Jessica; Utria, Alan F.; Bellizzi, Andrew M.; Dillon, Joseph S.; O'Dorisio, Thomas M.; Howe, James R.

doi:10.1245/s10434-018-6676-2

Cited by 40 publications

(22 citation statements)

References 27 publications

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“…The majority of primary tumours are slowly growing submucosal lesions, only a few millimetres in size (60% ≤ 20 mm), which invade the lamina propria or submucosa or the muscularis propria and are classified as pT1 or pT2 (Table 1 ). The lesions are more often located in the ileum (76%) than in the distal jejunum (24%) and may be multiple in up to 54% of cases [ 32 , 33 , 34 •, 35 ].…”

Section: Functionalitymentioning

confidence: 99%

How to Manage Small Intestine (Jejunal and Ileal) Neuroendocrine Neoplasms Presenting with Liver Metastases?

2021

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Purpose of Review Small intestinal neuroendocrine neoplasms (siNENs) are slowly growing tumours with a low malignant potential. However, more than half of the patients present with distant metastases (stage IV) and nearly all with locoregional lymph node (LN) metastases at the time of surgery. The value of locoregional treatment is discussed controversially. Recent Findings In stage I to III disease, locoregional surgery was currently shown to be curative prolonging survival. In stage IV disease, surgery may prolong survival in selected patients with the chance to cure locoregional disease besides radical/debulking liver surgery. It may improve the quality of life and may prevent severe local complications resulting in a state of chronic malnutrition and severe intestinal ischaemia or bowel obstruction. Summary Locoregional tumour resection offers the opportunity to be curative or to focus therapeutically on liver metastasis, facilitating various other therapeutic modalities. Risks and benefits of the surgical intervention need to be balanced individually.

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Section: Functionalitymentioning

confidence: 99%

How to Manage Small Intestine (Jejunal and Ileal) Neuroendocrine Neoplasms Presenting with Liver Metastases?

2021

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“…Manual palpation of the entire small bowel maximizes the detection of multiple synchronous tumors, missed in more than 60% of patients on preoperative imaging [ 6 , 59 , 60 ]. However, palpation still remains imperfect, as more lesions are discovered by pathology, assuming that small primary tumors may be left in place [ 17 ].…”

Section: Surgerymentioning

confidence: 99%

“…Figure 1 summarizes SI-NET classical presentation. SI-NET primary tumors are usually small (<20 mm), distal in the ileum, and multiple in 30% to 50% of cases [ 4 , 5 , 6 ]. Mesenteric lymph node metastases (MLNM) are present in more than 80% of patients at diagnosis, regardless of the size of the primary tumor [ 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Surgery and Perioperative Management in Small Intestinal Neuroendocrine Tumors

Deguelte¹,

Perrier²,

Hammoutene³

et al. 2020

JCM

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Small-intestinal neuroendocrine tumors (SI-NETs) are the most prevalent small bowel neoplasms with an increasing frequency. In the multimodal management of SI-NETs, surgery plays a key role, either in curative intent, even if R0 resection is feasible in only 20% of patients due to advanced stage at diagnosis, or palliative intent. Surgeons must be informed about the specific surgical management of SI-NETs according to their hormonal secretion, their usual dissemination at the time of diagnosis and the need for bowel-preserving surgery to avoid short bowel syndrome. The aim of this paper is to review the surgical indications and techniques, and perioperative and postoperative management of SI-NETs.

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“…Small intestinal NETs (SI-NETs), first described by Oberndorf et al in 1907 [4], are the most common gastrointestinal NETs, and SI-NETs have recently become more common than adenocarcinomas [5]. The ileum is the most common location of SI-NETs, with two-thirds of patients having a tumor in the final 100 cm of the small bowel [6]. The highest prevalence of SI-NETs (38%) is found in patients between 50 to 64 years of age [7], with a slight prevalence in male patients (5.35/100 000/years) [2].…”

Section: Introductionmentioning

confidence: 99%

Unexpected Finding of a Small Intestinal Neuroendocrine Tumor: A Case Report and Literature Review

et al. 2020

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Unusual clinical course Background:The incidence of neuroendocrine tumors (NETs) has increased in recent years. They can affect every area of the human body that presents cells with a secretory function. In this report, we focus on gastrointestinal NETs. The small bowel (SI) is the most affected area and SI-NETs have recently become more common than adenocarcinomas. Inside the small intestine, the appendix suffers from this pathology more than other organs. Case Report:Our case report deals with a 70 years-old man with extensive abdominal pain due to ingestion of an apricot kernel. A CT abdominal scan showed, around the kernel, a mechanical ileus with inflammation of the distal ileum and thickening of the intestinal wall. During the operation, we replaced laparoscopy with mini-laparotomy, performing an ileocecectomy due to suspicion of a tumor lesion. The histopathological exam revealed a welldifferentiated neuroendocrine tumor (NET G1) of the distal ileum. Conclusions:This case report shows that SI-NETs can be found in cases of small bowel occlusion. Depending on the size and distinction, such patients can have good survival rates.

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The Distal Predilection of Small Bowel Neuroendocrine Tumors

Abstract: SBNETs are frequently multifocal and most commonly located within 100 cm of the ICV. SBNETs are less prevalent proximally in the small bowel, which may result from anatomic differences in enterochromaffin cell density, hormonal factors, or environmental exposures in the distal SB.

Cited by 40 publications

References 27 publications

How to Manage Small Intestine (Jejunal and Ileal) Neuroendocrine Neoplasms Presenting with Liver Metastases?

How to Manage Small Intestine (Jejunal and Ileal) Neuroendocrine Neoplasms Presenting with Liver Metastases?

Surgery and Perioperative Management in Small Intestinal Neuroendocrine Tumors

Unexpected Finding of a Small Intestinal Neuroendocrine Tumor: A Case Report and Literature Review

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