Neuroendocrine Tumors – Symptoms and Diagnosis
Having a brain tumor is scary enough, but what about the side effects? The good news is that there are treatments available. These treatments include surgery, chemotherapy, and radiation. The bad news is that these treatments are not guaranteed to cure cancer. In fact, most treatments are not successful. However, they can help to reduce the symptoms.
Symptoms
Symptoms of neuroendocrine tumors are varied and depend on the location and stage of the tumor. Some tumors are benign while others are malignant. Symptoms may include fatigue, loss of appetite, unexplained weight loss, cough, wheezing, dizziness, shortness of breath, changes in bowel habits, heart problems, and other problems.
Neuroendocrine tumors are usually found in the pancreas, lungs, abdomen, rectum, and stomach. They can also occur in other parts of the body. Some tumors produce excessive amounts of hormones, which can affect the digestive system. Some tumors may also spread quickly.
Some types of neuroendocrine tumors are benign and slow-growing. Others are malignant and spread quickly. Malignant tumors are treated with surgery and radiation therapy. Some tumors may also be treated with targeted drug therapy, such as everolimus and sunitinib.
The incidence of neuroendocrine tumors has been rising fivefold over the past few decades. These tumors are characterized by nests of small, round cells that are found in the nuclei of the tumor. The nuclei of these tumors contain eosinophilic granules.
Neuroendocrine tumors may occur due to an interruption in the DNA signals, which causes cell abnormalities. Neuro-cells are hormone-producing cells that are part of the endocrine system.
In many cases, neuroendocrine tumors are diagnosed by imaging tests. Imaging tests include ultrasound, MRI, CT scan, and Positron Emission Tomography. These imaging tests create a picture of the tumor, and the doctor can assess the size and location of the tumor.
Neuroendocrine tumors can be treated with surgery or radiation therapy. Surgical treatment is preferred for malignant tumors. Radiation therapy may also be used to shrink the tumor before surgery. Chemotherapy is also used in certain cases.
Diagnosis
Unlike other tumors, diagnosis of neuroendocrine tumors can be challenging. Patients are often left feeling anxious, uncertain, and overwhelmed. They also may require several tests to determine the cause of their tumors. The right diagnosis is critical to successful treatment.
Neuroendocrine tumors are a heterogeneous group of tumors that are classified into two subtypes: poorly differentiated neuroendocrine tumors (ND-NET) and well-differentiated neuroendocrine tumors (WD-NET). ND-NETs are carcinomas that express the same neuroendocrine markers as WD-NETs. WD-NETs are classified as well-differentiated if they express a proliferation index (PI) greater than two percent, but less than 15 percent.
Neuroendocrine tumors can be found in many different organs. Although they may occur anywhere in the body, they are most commonly found in the pancreas and gastrointestinal (GI) tract. Some neoplasms are also found in the lungs and brain.
Although neuroendocrine tumors are generally benign, they can cause carcinoid syndrome. Carcinoid syndrome is characterized by flushing and other symptoms that can occur when the tumor secretes bioactive hormones.
Neuroendocrine tumors are known to increase in prevalence. Increasing awareness of NET can help expedite diagnosis and facilitate referral for treatment. A recent survey was conducted to assess the burden of neuroendocrine tumors in France. In the survey, the researchers found a significant difference in the diagnosis and treatment of neuroendocrine tumors between France and the United States.
A key area of concern was the negative impact that NET had on patients’ quality of life. Researchers used a web-based survey to gather information from patients about their symptoms and interactions with the healthcare system. The survey was adapted to include questions about awareness of NET and delays in diagnosis.
Treatment
Approximately 4,000 people are diagnosed with lung neuroendocrine tumors each year. Most tumors are locally inoperable, and a surgical procedure can be used to remove the primary tumor. In addition, a liver transplant is a treatment option for cancer patients with a primary tumor that has spread to the liver. This surgery uses a portion of the liver from a living donor.
Treatment for neuroendocrine tumors is highly individualized and may involve surgery, chemotherapy, radiation therapy, and somatostatin analogs. A multidisciplinary team approach is important for treating neuroendocrine tumors. This team may include a doctor, a nurse, a psychologist, a physician assistant, and other health care providers.
There are many types of neuroendocrine tumors, including those that produce hormones, such as thyroid and pituitary gland tumors. Neuroendocrine tumors can appear in almost any part of the body. They are most often located in the lungs, but may also appear in the pancreas, digestive system, and pituitary gland.
Treatment for neuroendocrine tumors can vary widely from patient to patient, and many aspects remain unclear. However, a number of comprehensive guidelines for neuroendocrine tumors are in place. These guidelines include a staging system. This system incorporates factors such as tumor diameter, tumor size, and resectability. The American Joint Committee on Cancer has proposed a staging system for NETs, which has been clinically validated.
Peptide receptor radionuclide therapy is an experimental treatment for neuroendocrine tumors. A radioactive substance is a combination of a drug with a radioactive substance. Peptide receptor radionuclide therapies are often used in combination with chemotherapy. This type of therapy has shown some promise in treating metastatic NETs.
In the near future, the main challenge is designing clinical trials to test new treatments. Recent phase III studies have evaluated octreotide, sunitinib, and lanreotide. However, there are many questions regarding the efficacy of these treatments.
Spread to the liver
Several non-invasive imaging studies have been developed to detect neuroendocrine tumors in the liver. However, these studies are not conclusive. Although they are helpful in detecting neuroendocrine tumors in the liver, their sensitivity is low. In addition, they can lead to false negative results. Therefore, it is important to perform a percutaneous puncture to determine the location of the primary tumor.
The most common neuroendocrine tumors to metastasize to the liver are gastrointestinal NETs. They account for 50% of patients with neuroendocrine pancreatic tumors. These tumors vary in size and malignant potential. Approximately half of them do not have hormone-related symptoms. The remaining half present with symptoms related to neuroendocrine function, such as hypersecretion of amines.
Neuroendocrine tumors can cause liver metastases, which can present with a variety of symptoms. They may include carcinoid syndrome, acid hypersecretion, and serotonin syndrome. They can also worsen overall survival.
Liver metastases can be treated through either open or laparoscopic surgery. Laparoscopic surgery is a cost-effective approach. In addition, it may be less invasive for patients with neuroendocrine tumors. The goal of a liver-directed approach is to decrease the amount of tumor tissue removed while improving the overall survival of the patient.
Treatment strategies for neuroendocrine tumors with liver metastases include systemic therapy and loco-regional therapy. Surgical resection of the primary tumor may be beneficial in patients with severe symptoms. Surgery may also help to reduce hormone activity. However, it is important to note that surgery is not required for all patients with liver metastases. It is important to consider liver resection only after the primary tumor has been adequately controlled.
In addition, new strategies for systemic treatment are available. Biotherapy with somatostatin analogs, interferon, and peptide receptor radionuclide therapy are all options. The response of the tumor to systemic therapy depends on the grade and stage of the tumor, as well as the proliferation rate.
Histopathology
Various factors, including pathology, clinical symptoms, and anatomical distribution, play a role in the diagnosis and management of neuroendocrine tumors. Histopathology can provide information on the nature and behavior of the tumor, helping to determine the next course of treatment. A variety of techniques have been developed to facilitate the pathology of neuroendocrine tumors.
The clinical features of neuroendocrine neoplasms vary between organs. The primary sites for these tumors are the GI tract, pancreas, and lungs. Other sites, such as the appendices and colon, are also common. However, neuroendocrine tumors are rare in the bile ducts.
Neuroendocrine tumors are classified according to the World Health Organization’s 2010 classification. This classification divides tumors into four groups based on differentiation, anatomic distribution, and clinical features. The presence of some cytoplasmic proteins can also help in the classification of these tumors.
In general, neuroendocrine tumors are graded based on their differentiation. Well-differentiated neuroendocrine neoplasms are graded as grade one or two, while poorly differentiated tumors are grade three. Both types of neuroendocrine tumors have some features in common, such as epithelioid granular cytoplasm and chromogranin expression.
Some endocrine tumors are classified based on their genetic background. Some of the most common genetic alterations are site-specific. Others, such as those related to the MEN1 oncosuppressor gene, are rare and occur in only a few cases.
MEN1-related carcinoids have a poor prognosis. Treatment is often surgical. However, in some cases, surgery is not possible. Surgical resection is the mainstay of therapy. The survival rate in these patients does not differ between patients who have surgery and those who have no surgery.
Neuroendocrine tumors have become more common in recent years, but pathologists still have to use special techniques to diagnose them. Moreover, the clinical behavior of these tumors varies, and the diagnosis can be difficult.
Health Sources:
Health A to Z. (n.d.). HSE.ie. https://www2.hse.ie/az/
U.S. National Library of Medicine. (n.d.). https://www.ncbi.nlm.nih.gov/
Directory Health Topics. (n.d.). https://www.healthline.com/directory/topics
Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
Health Conditions A-Z Sitemap. (n.d.). EverydayHealth.com. https://www.everydayhealth.com/conditions/
