Digestive neuroendocrine tumors: Clinic and histology. Hospital of San José, January 2005 to May 2007

Tumores neuroendocrinos digestivos: Clínica e histología. Hospital de San José, enero 2005 a mayo 2007

Objectives, neuroendocrine tumors are infrequent entities so their natural history and outcome are poorly understood. In the present study, the clinical and histological characteristics of those diagnosed in a period of two years are described. Methodology: descriptive, retrospective study of case series. A case is defined as any patient diagnosed with digestive NET performed by the pathology service between January 2005 and May 2007. Results: at the Hospital de San José from January 2005 to May 2007, nine cases of patients with NETs were diagnosed, 33.3% in women and 66.7% in men. The average age was 50.3 years (range 12 to 77 years). The most frequent histological type according to the WHO classification was the well-differentiated NET in 77.8%. 66.7% were asymptomatic and 33.3% presented some type of manifestation, such as diarrhea and acid-peptic disease with 22.2% each. In women, 100% of the lesions were asymptomatic and 50% in men. In the series there was a metastasis that occurred in the male sex. Infiltration of the wall in the muscle was seen in 55.6%. Angioinvasion only occurred in a male patient who also presented metastasis to the liver. When the Ki67 value is less than 1%, metastasis does not occur. The sites of primary localization of the most frequent digestive neuroendocrine tumors were duodenum and appendix (22.2% each) and in the extragastrointestinals it was the lung (22.2%). 77.8% of patients had some procedure, the most common of which was polypectomy (42.9%). After the procedure, 50% of the patients presented total improvement of the symptoms and the rest partially. Compliance with subsequent follow-up was higher in women with 66.6% and 33.3% for men. Abbreviations: TNE, neuroendocrine tumors.

1. Robin P, Drucker D. Gastrointestinal hormones and gut endocrine tumors. In: Larsen PR, Kronenberg H, Melmed S, Polonsky K. Williams textbook of endocrinology. 10th ed. Philadelphia: W.B. Saunders; 2003. p. 1777-96.

2. Kaltsas GA, Besser GM, Grossman AB. The diagnosis and medical management of advanced neuroendocrine tumors. Endocr Rev. 2004 Jun;25(3):458-511.

3. Tomassetti P, Migliori M, Lalli S, Campana D, Tomassetti V, Corinaldesi R. Epidemiology, clinical features and diagnosis of gastroenteropancreatic endocrine tumours. Ann Oncol. 2001;12 Suppl 2:S95-9.

4. Plückinger U, Rindi G, Arnold R, Eriksson B, Krenning EP, de Herder WW, Goede A, Caplin M, Oberg K, Reubi JC, Nilsson O, Delle Fave G, Ruszniewski P, Ahlman H, Wiedenmann B; European Neuroendocrine Tumour Society. Guidelines for the diagnosis and treatment of neuroendocrine gastrointestinal tumours. A consensus statement on behalf of the European Neuroendocrine Tumour Society (ENETS). Neuroendocrinology. 2004;80(6):394-424.

5. Jensen RT, Niederle B, Mitry E, Ramage JK, Steinmuller T, Lewington V, Scarpa A, Sundin A, Penen A, Gross D, O'Connor JM, Pauwels S, Kloppel G; Frascati Consensus Conference; European Neuroendocrine Tumor Society. Gastrinoma (duodenal and pancreatic).Neuroendocrinology. 2006;84(3):173-82.

6. Plóckinger U, Rindi G, Arnold R, Eriksson B, Krenning EP, de Herder WW, Goede A, Caplin M, Oberg K, Reubi JC, Nilsson O, Delle Fave G, Ruszniewski P, Ahlman H, Wiedenmann B; European Neuroendocrine Tumour Society. Guidelines for the diagnosis and treatment of neuroendocrine gastrointestinal tumours. A consensus statement on behalf of the European Neuroendocrine Tumour Society (ENETS). Neuroendocrinology. 2004;80(6):394-424.

7. Modlin IM, Champaneria MC, ChanAK, Kidd M. A threedecade analysis of 3,911 small intestinal neuroendocrine tumors: the rapid pace of no progress. Am J Gastroenterol. 2007 Jul;102(7):1464-73.