Surgical treatment of pancreatic endocrine tumors in multiple endocrine neoplasia type 1.

Clinics
Marcel Cerqueira Cesar Machado

Abstract

Surgical approaches to pancreatic endocrine tumors associated with multiple endocrine neoplasia type 1 may differ greatly from those applied to sporadic pancreatic endocrine tumors. Presurgical diagnosis of multiple endocrine neoplasia type 1 is therefore crucial to plan a proper intervention. Of note, hyperparathyroidism/multiple endocrine neoplasia type 1 should be surgically treated before pancreatic endocrine tumors/multiple endocrine neoplasia type 1 resection, apart from insulinoma. Non-functioning pancreatic endocrine tumors/multiple endocrine neoplasia type 1 >1 cm have a high risk of malignancy and should be treated by a pancreatic resection associated with lymphadenectomy. The vast majority of patients with gastrinoma/multiple endocrine neoplasia type 1 present with tumor lesions at the duodenum, so the surgery of choice is subtotal or total pancreatoduodenectomy followed by regional lymphadenectomy. The usual surgical treatment for insulinoma/multiple endocrine neoplasia type 1 is distal pancreatectomy up to the mesenteric vein with or without spleen preservation, associated with enucleation of tumor lesions in the pancreatic head. Surgical procedures for glucagonomas, somatostatinomas, and vipomas/ multiple endocrin...Continue Reading

Citations

Dec 29, 2015·International Journal of Surgery·Michele OrdituraFerdinando De Vita
Jan 3, 2013·Asia-Pacific Journal of Clinical Oncology·Richard W Carroll
Jul 15, 2015·The Lancet. Diabetes & Endocrinology·Christopher J YatesRajesh V Thakker
May 22, 2016·Endocrine-related Cancer·Yulong Li, William F Simonds

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Methods Mentioned

BETA
pancreatectomy
surgical
surgical resection

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