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Gastrointestinal Neuroendocrine Tumor

MaineHealth provides services for the diagnosis and treatment of neuroendocrine tumors.  Is estimated that 8,000 patients will be diagnosed with gastrointestinal neuroendocrine tumors every year. Work by multiple investigators, including members of our group; have documented the rapid increase in the incidence of this disease over the last several decades.

 

The World Health Organization recommends these tumors be called gastroenteropancreatic neuroendocrine tumor (GEP-NET).

 

What are gastrointestinal neuroendocrine tumors?

 

Gastrointestinal neuroendocrine tumors arise from endocrine (hormone producing) and nerve cells within the gastrointestinal tract. Because they arise from hormone-producing cells patients may have symptoms of hormone excess. These tumors can arise anywhere in the gastrointestinal tract including stomach, small bowel, appendix, colon, and rectum. Factors that determine how aggressive these tumors will be including location, size, depth, and pathologic features (i.e. grade). Many, but not all, of these tumors, are slow-growing.

 

Symptoms and diagnosis

 

Many patients with gastrointestinal neuroendocrine tumors will present with minimal or no symptoms. For these patients, the diagnosis is frequently made on an imaging study (CT and MRI scans) or endoscopic procedure performed for another reason.

 

Symptoms may arise from tumor mass or hormones made by the tumors. Tumors can cause fullness, loss of appetite, weight loss, abdominal pain, change in bowel function, and jaundice (yellowing of the skin).

 

Symptoms from hormone (serotonin, insulin, gastrin, glucagon, vasoactive intestinal protein, and somatostatin) excess include low or high blood sugar, flushing, diarrhea, skin rash, difficult to control stomach ulcers, and fevers or night sweats.

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Risk factors for gastrointestinal neuroendocrine tumors

 

The only clear risk factors for gastrointestinal neuroendocrine tumors are age and inherited genetic disorders such as multiple endocrine neoplasia and von Hippel-Lindau disease.

Treatment depends on tumor size and location

 

The ideal treatment for gastrointestinal neuroendocrine tumors varies depending on location, tumor size, pathologic features, depth, and patient’s health. Treatment options include observation, endoscopic removal, complex gastrointestinal surgery, delivery of chemotherapy or radiation directly into tumors (embolization), ablation (destroying tumors with heat energy), and precision radiation therapy. The multidisciplinary gastrointestinal oncologic team at Maine Medical Center evaluates individual patients and therapeutic options to design a patient-centered treatment regimen.

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