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L. Larsson, L. Grimelius, R. Håkanson, J. Rehfeld, F. Stadil, J. Holst, L. Angervall, F. Sundler (1975)
Mixed endocrine pancreatic tumors producing several peptide hormones.The American journal of pathology, 79 2
L. Kvols, C. Moertel, M. Connell, A. Schutt, J. Rubin, R. Hahn (1987)
Treatment of the Malignant Carcinoid SyndromeSurvey of Anesthesiology
L. Kvols, C. Moertel, M. O’connell, A. Schutt, J. Rubin, R. Hahn (1986)
Treatment of the malignant carcinoid syndrome. Evaluation of a long-acting somatostatin analogue.The New England journal of medicine, 315 11
Debas Ht (1988)
Clinical significance of gastrointestinal hormones.Advances in surgery, 21
H. Debas, G. Gittes (1993)
Somatostatin analogue therapy in functioning neuroendocrine gut tumors.Digestion, 54 Suppl 1
M. Wolfe, R. Jensen (1987)
Zollinger-Ellison syndrome. Current concepts in diagnosis and management.The New England journal of medicine, 317 19
J. Norton, P. Sugarbaker, J. Doppman, R. Wesley, P. Maton, J. Gardner, R. Jensen (1986)
Aggressive Resection of Metastatic Disease in Selected Patients with Malignant GastrinomaAnnals of Surgery, 203
Oberg K Makridis C (1990)
Surgical treatment of mid-gut carcinoid tumorsWorld J Surg, 14
L. Kvols, M. Brown, M. O'Connor, J. Hung, R. Hayostek, J. Reubi, S. Lamberts (1993)
Evaluation of a radiolabeled somatostatin analog (I-123 octreotide) in the detection and localization of carcinoid and islet cell tumors.Radiology, 187 1
Brett Sheppard, J. Norton, J. Doppman, P. Maton, Jerry Gardner, Robert Jensen (1989)
Management of islet cell tumors in patients with multiple endocrine neoplasia: a prospective study.Surgery, 106 6
T. Rösch, C. Lightdale, J. Botet, G. Boyce, Michael Sivak, K. Yasuda, Norbert Heyder, L. Palazzo, H. Dancygier, V. Schusdziarra, M. Classen (1992)
Localization of pancreatic endocrine tumors by endoscopic ultrasonography.The New England journal of medicine, 326 26
S. Sugg, J. Norton, D. Fraker, D. Metz, J. Pisegna, V. Fishbeyn, R. Benya, T. Shawker, J. Doppman, R. Jensen (1993)
A Prospective Study of Intraoperative Methods to Diagnose and Resect Duodenal GastrinomasAnnals of Surgery, 218
C. Townsend, J. Thompson (1985)
Surgical management of tumors that produce gastrointestinal hormones.Annual review of medicine, 36
Moertel CG Kvols LK (1986)
Treatment of the malignant carcinoid syndromeN Engl J Med, 315
R. Kent, J. Heerden, L. Weiland (1981)
Nonfunctioning islet cell tumors.Annals of surgery, 193 2
A. Bale, J. Norton, E. Wong, J. Fryburg, P. Maton, E. Oldfield, E. Streeten, G. Aurbach, M. Brandi, E. Friedman (1991)
Allelic loss on chromosome 11 in hereditary and sporadic tumors related to familial multiple endocrine neoplasia type 1.Cancer research, 51 4
R. Vinayek, Michael Amantea, P. Maton, Harold Frucht, J. Gardner, Robert Jensen (1991)
Pharmacokinetics of oral and intravenous omeprazole in patients with the Zollinger-Ellison syndrome.Gastroenterology, 101 1
Abstract Objective: To review our experiences in order to high-light some important lessons learned in the treatment of patients with neuroendocrine gut neoplasms. Design: Retrospective analysis of case series of 70 patients with neuroendocrine gut neoplasms treated between 1983 and 1993. The clinical features of individual patients illustrate lessons in surgical treatment. Setting: University hospitals with tertiary care referral practice. Interventions: The main intervention was abdominal exploration in 43 patients, with resection of the primary tumor in 39 and of hepatic metastases in four. Main Outcome Measures: To describe the tumors seen and to identify major lessons learned. Results: Of 70 patients with neuroendocrine tumors treated, 31 had carcinoid tumors, 10 each had insulinomas and gastrinomas, five had vipomas, nine had nonfunctioning islet cell tumors, three had glucagonomas, and one each had somatostatinoma and a possible cholecystokinin-secreting tumor (or CCKoma). Important lessons learned include: (1) the importance of preoperative tumor localization; (2) in multiple endocrine neoplasia, type I syndrome, the tumor found may not be the one responsible for the patient's symptoms; (3) solitary sporadic tumors secreting multiple peptides may mimic multiple tumors in multiple endocrine neoplasia, type I syndrome; (4) one needs to be prepared for the unexpected, such as the carcinoid crisis; (5) resection may sometimes be necessary even with advanced local disease; and (6) selected patients may benefit from pancreaticoduodenectomy. Conclusions: These rare tumors are interesting in their clinical presentation and can be challenging in their treatment.(Arch Surg. 1994;129:965-972) References 1. Debas HT. Clinical significance of gastrointestinal hormones . Adv Surg . 1987: 21:157-188. 2. Bale AE, Norton JA, Wong EL. Allelic loss of chromosome 11 in hereditary and sporadic tumors related to familial multiple endocrine neoplasia type I . Cancer Res . 1991;51:1154-1157. 3. Wolfe MM, Jensen RT. Zollinger-Ellison syndrome: current concepts in diagnosis and management . N Engl J Med . 1987;317:1200-1209.Crossref 4. Larsson LI, Grimelias L, Hakanson R. Mixed endocrine pancreatic tumors producing several peptide hormones . Am J Pathol . 1975;79:271-278. 5. Townsend CM Jr, Thompson JC. Surgical management of tumors that produce gastrointestinal hormones . Annu Rev Med . 1985;36:111-126.Crossref 6. Makridis C, Oberg K, Juhlin C, et al. Surgical treatment of mid-gut carcinoid tumors . World J Surg . 1990;14:377-382.Crossref 7. Kvols LK, Moertel CG, O'Connell MJ. Treatment of the malignant carcinoid syndrome . N Engl J Med . 1986;315:663-666.Crossref 8. Debas HT, Gittes G. Somatostatin analogue therapy in functioning neuroendocrine gut tumors . Digestion . 1993;54( (suppl 1) ):68-71.Crossref 9. Vinayek R, Amantea MA, Maton PN, Frucht H, Gardner JD, Jensen RT. Pharmacokinetics of oral and intravenous omeprazole in patients with Zollinger-Ellison syndrome . Gastroenterology . 1991;101:138-147. 10. Sugg SL, Norton JA, Fraker DL, et al. A prospective study of intraoperative methods to diagnose and resect duodenal gastrinomas . Ann Surg . 1993;218:138-144.Crossref 11. Rosch T, Lightdale CJ, Botet JF, et al. Localization of pancreatic endocrine tumors by endoscopic ultrasonography . N Engl J Med . 1992;326:1721-1726.Crossref 12. Sheppard BC, Norton JA, Doppman JL, Maton PN, Gardiner JD, Jensen RT. Management of islet cell tumors in patients with multiple endocrine neoplasia: a prospective study . Surgery . 1989;106:1108-1117. 13. Kent RB, van Heerden JA, Weiland LH. Non-functioning islet cell tumors . Ann Surg . 1981;193:185-190.Crossref 14. Norton JA, Sugerbaker PH, Doppman JL, et al. Aggressive resection of metastatic disease in selected patients with malignant gastrinoma . Ann Surg . 1986; 203:352-359.Crossref 15. Kvols LK, Brown ML, O'Connell MJ. Evaluation of the radiolabelled somatostatin analog (123I-octreotide) in the detection and localization of carcinoid and islet cell tumors . Radiology . 1993;187:129-133.Crossref
Archives of Surgery – American Medical Association
Published: Sep 1, 1994
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