GASTROENTEROPANCREATIC NEUROENDOCRINE TUMORS (GEP-NETs) - APPROACH TO DIAGNOSIS AND MANAGEMENT
نویسنده
چکیده
Clinical Presentation and Natural History The clinical course of patients with GEP-NETs is highly variable. Some patients with indolent tumors remain symptom free for year even without treatment. Most patients with non-functioning tumors due to lack of symptoms related to hormonal hypersecretion are diagnosed late in the course of the disease. Clinical signs and symptoms are due to tumor mass with local invasion and distant metastases. These symptoms may include abdominal pain, weight loss, anorexia, nausea, jaundice, intra-abdominal mass and bleeding. Patients with functioning metastatic islet cell tumors typically manifest with symptoms caused by specific type of hormone produced by the tumor. With metastatic carcinoids, the secretion of serotonin and other vasoactive substances causes the carcinoid syndrome which manifests as episodic flushing, wheezing, diarrhea, pellagra-like skin lesions and eventual right-sided valvular heart disease. The carcinoid syndrome is most commonly seen with mid-gut carcinoid tumors (small intestine, appendix and proximal large bowel) and mostly in the setting of metastatic disease3,4,5,6. GASTROENTEROPANCREATIC NEUROENDOCRINE TUMORS (GEP-NETs) APPROACH TO DIAGNOSIS AND MANAGEMENT.
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