Abstract
Background: Duodenal neuroendocrine neoplasms (dNENs) are rare tumors, which usually show good prognosis. The optimal management of these tumors is still far from being clearly understood because of their rarity and the poor level of knowledge about their natural history. Herein, we have reviewed the literature on dNENs to collect and analyze the current data on epidemiology, diagnosis and management of these rare tumors. Methods: Bibliographical searches were performed in PubMed, using the following keywords: duodenal neuroendocrine neoplasm; duodenum; gastrinoma; diagnosis; therapy; guidelines. We searched for all relevant articles published over the last 15 years. Non-English language papers were excluded. Results: We reviewed the pertinent articles about dNENs. Upper gastrointestinal endoscopy with biopsy is the cornerstone of the dNENs diagnostic process. Endoscopic ultrasound with fine-needle aspiration/biopsy should be performed in order to locally stage the disease and in all cases of non-diagnostic endoscopy. Endoscopic or complete surgical removal of the primary lesion is the recommended treatment and is generally achievable for the majority of the patients. A less aggressive approach may be suggested for well-differentiated low-stage tumors. After NEN removal, patients should be closely followed-up especially during the first 3 years by endoscopic examination, imaging tests and CgA measurements. Conclusions: The multi-disciplinary approach and the preservation of the quality of life of the patients play a key role in the therapeutic process for dNENs. Further studies are needed to better define standardized guidelines specific to dNENs, including optimal management approaches and follow-up intervals.
| Original language | English |
|---|---|
| Pages (from-to) | 835-842 |
| Number of pages | 8 |
| Journal | Scandinavian Journal of Gastroenterology |
| Volume | 53 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jul 3 2018 |
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Keywords
- diagnosis
- Duodenal neuroendocrine neoplasms
- duodenum
- gastrinoma
- guidelines
- therapy
ASJC Scopus subject areas
- Gastroenterology
Cite this
Duodenal neuroendocrine neoplasms : a still poorly recognized clinical entity. / Rossi, Roberta Elisa; Rausa, Emanuele; Cavalcoli, Federica; Conte, Dario; Massironi, Sara.
In: Scandinavian Journal of Gastroenterology, Vol. 53, No. 7, 03.07.2018, p. 835-842.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Duodenal neuroendocrine neoplasms
T2 - a still poorly recognized clinical entity
AU - Rossi, Roberta Elisa
AU - Rausa, Emanuele
AU - Cavalcoli, Federica
AU - Conte, Dario
AU - Massironi, Sara
PY - 2018/7/3
Y1 - 2018/7/3
N2 - Background: Duodenal neuroendocrine neoplasms (dNENs) are rare tumors, which usually show good prognosis. The optimal management of these tumors is still far from being clearly understood because of their rarity and the poor level of knowledge about their natural history. Herein, we have reviewed the literature on dNENs to collect and analyze the current data on epidemiology, diagnosis and management of these rare tumors. Methods: Bibliographical searches were performed in PubMed, using the following keywords: duodenal neuroendocrine neoplasm; duodenum; gastrinoma; diagnosis; therapy; guidelines. We searched for all relevant articles published over the last 15 years. Non-English language papers were excluded. Results: We reviewed the pertinent articles about dNENs. Upper gastrointestinal endoscopy with biopsy is the cornerstone of the dNENs diagnostic process. Endoscopic ultrasound with fine-needle aspiration/biopsy should be performed in order to locally stage the disease and in all cases of non-diagnostic endoscopy. Endoscopic or complete surgical removal of the primary lesion is the recommended treatment and is generally achievable for the majority of the patients. A less aggressive approach may be suggested for well-differentiated low-stage tumors. After NEN removal, patients should be closely followed-up especially during the first 3 years by endoscopic examination, imaging tests and CgA measurements. Conclusions: The multi-disciplinary approach and the preservation of the quality of life of the patients play a key role in the therapeutic process for dNENs. Further studies are needed to better define standardized guidelines specific to dNENs, including optimal management approaches and follow-up intervals.
AB - Background: Duodenal neuroendocrine neoplasms (dNENs) are rare tumors, which usually show good prognosis. The optimal management of these tumors is still far from being clearly understood because of their rarity and the poor level of knowledge about their natural history. Herein, we have reviewed the literature on dNENs to collect and analyze the current data on epidemiology, diagnosis and management of these rare tumors. Methods: Bibliographical searches were performed in PubMed, using the following keywords: duodenal neuroendocrine neoplasm; duodenum; gastrinoma; diagnosis; therapy; guidelines. We searched for all relevant articles published over the last 15 years. Non-English language papers were excluded. Results: We reviewed the pertinent articles about dNENs. Upper gastrointestinal endoscopy with biopsy is the cornerstone of the dNENs diagnostic process. Endoscopic ultrasound with fine-needle aspiration/biopsy should be performed in order to locally stage the disease and in all cases of non-diagnostic endoscopy. Endoscopic or complete surgical removal of the primary lesion is the recommended treatment and is generally achievable for the majority of the patients. A less aggressive approach may be suggested for well-differentiated low-stage tumors. After NEN removal, patients should be closely followed-up especially during the first 3 years by endoscopic examination, imaging tests and CgA measurements. Conclusions: The multi-disciplinary approach and the preservation of the quality of life of the patients play a key role in the therapeutic process for dNENs. Further studies are needed to better define standardized guidelines specific to dNENs, including optimal management approaches and follow-up intervals.
KW - diagnosis
KW - Duodenal neuroendocrine neoplasms
KW - duodenum
KW - gastrinoma
KW - guidelines
KW - therapy
UR - http://www.scopus.com/inward/record.url?scp=85050399195&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050399195&partnerID=8YFLogxK
U2 - 10.1080/00365521.2018.1468479
DO - 10.1080/00365521.2018.1468479
M3 - Review article
AN - SCOPUS:85050399195
VL - 53
SP - 835
EP - 842
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
SN - 0036-5521
IS - 7
ER -