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

Machado, Marcel Cerqueira Cesar

Clinics; v. 67 n. supl.1 (2012); 145-148

Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo 2012-01-01

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  • Título:
    Surgical treatment of pancreatic endocrine tumors in multiple endocrine neoplasia type 1
  • Autor: Machado, Marcel Cerqueira Cesar
  • Assuntos: Men1; Pancreatic Tumors; Endocrine Tumors; Pancreatic Endocrine Tumors; Neuroendocrine Tumors
  • É parte de: Clinics; v. 67 n. supl.1 (2012); 145-148
  • Descrição: 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 endocrine neoplasia type 1 are similar to those applied to sporadic pancreatic endocrine tumors. Some of these surgical strategies for pancreatic endocrine tumors/multiple endocrine neoplasia type 1 still remain controversial as to their proper extension and timing. Furthermore, surgical resection of single hepatic metastasis secondary to pancreatic endocrine tumors/multiple endocrine neoplasia type 1 may be curative and even in multiple liver metastases surgical resection is possible. Hepatic trans-arterial chemo-embolization is usually associated with surgical resection. Liver transplantation may be needed for select cases. Finally, pre-surgical clinical and genetic diagnosis of multiple endocrine neoplasia type 1 syndrome and localization of multiple endocrine neoplasia type 1related tumors are crucial for determining the best surgical strategies in each individual case with pancreatic endocrine tumors.
  • Títulos relacionados: https://www.revistas.usp.br/clinics/article/view/19735/21799
  • Editor: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Data de criação/publicação: 2012-01-01
  • Formato: Adobe PDF
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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