Endocrine Abstracts

The classification and nomenclature of neuroendocrine neoplasms (NENs) is complex, can be confusing and has undergone major changes over the last three decades, as illustrated by the evolution in classification of GEP-NENs by the WHO. The 4th edition of the WHO’s classification of GEP-NENs was published in 2010. This edition is currently in use for gastrointestinal neuroendocrine neoplasm (GI-NEN) classification. The WHO 2010 classification introduced a strict ...

Chemotherapy has historically been the ‘work horse’ of medical oncology. An improved understanding of the biological behavious of neuroendocrine neoplasms has led to decision-making based on pathological characterisation of neuroendocrine neoplasms in to well-differentiated neuroendocrine tumours (NETs) vs poorly-differentiated neuroendocrine carcinomas (NECs). Platinum/etoposide has an established role in high-grade NECs with high responses, although these are often...

Medullar Thyroid cancer (MTC) is uncommon and a mixture of sporadic and familial. Surgery is the only curative treatment to date. Prophylactic surgery is required in the hereditary forms. No adjuvant post-operative treatment has demonstrated survival benefit. External radiotherapy may be used selectively. Calcitonin and CEA are used for post-operative monitoring of recurrence. At time of relapse consider whether there is a surgical option. The rate of doubling has prognostic v...

Duodenal neuroendocrine neoplasms (d-NENs) account for approximately 2% of all NENs, frequently encountered incidentally at endoscopy. They can be classified in a number of ways: ampullary/peri-ampullary and non-ampullary; gastrinomas, somatostatinomas, non-functional d-NENs, duodenal gangliocytic paragangliomas and high-grade poorly differentiated NECs. More than 90% arise in the 2st or 2nd part of the duodenum. ENETS guidelines suggest managing d-NENs according to size, with...

Gastroenteropancreatic Neuroendocrine Tumours (NETs) may lead to gastrointestinal symptoms directly or as a result of their treatment, for example surgical resection and/or somatostatin analogues (SSA). When these symptoms become severe, patients may develop a reduced ability to successfully digest and absorb nutrients in the diet. This may be specific due the area of resection, e.g. vitamin B12, or secondary from medication, e.g. SSA induced pancreatic exocrine insufficiency ...