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

dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMACHADO, Marcel Cerqueira Cesar
dc.date.accessioned2013-07-30T14:39:10Z
dc.date.available2013-07-30T14:39:10Z
dc.date.issued2012
dc.description.abstractSurgical 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 1-related tumors are crucial for determining the best surgical strategies in each individual case with pancreatic endocrine tumors.
dc.description.indexMEDLINE
dc.identifier.citationCLINICS, v.67, suppl.1, p.145-148, 2012
dc.identifier.doi10.6061/clinics/2012(Sup01)24
dc.identifier.issn1807-5932
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/374
dc.language.isoeng
dc.publisherHOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartofClinics
dc.rightsopenAccess
dc.rights.holderCopyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.subjectMEN1
dc.subjectPancreatic Tumors
dc.subjectEndocrine Tumors
dc.subjectPancreatic Endocrine Tumors
dc.subjectNeuroendocrine Tumors
dc.subject.othergastroenteropancreatic neuroendocrine tumors
dc.subject.otherzollinger-ellison-syndrome
dc.subject.otherprimary hyperparathyroidism
dc.subject.othermanagement
dc.subject.othercontroversies
dc.subject.otherintervention
dc.subject.otherguidelines
dc.subject.otherstrategy
dc.subject.othermen-1
dc.subject.wosMedicine, General & Internal
dc.titleSurgical treatment of pancreatic endocrine tumors in multiple endocrine neoplasia type 1
dc.typearticle
dc.type.categoryreview
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus12
hcfmusp.contributor.author-fmusphcMARCEL CERQUEIRA CESAR MACHADO
hcfmusp.description.beginpage145
hcfmusp.description.endpage148
hcfmusp.description.issuesuppl 1
hcfmusp.description.volume67
hcfmusp.lim.ref2012
hcfmusp.origemWOS
hcfmusp.origem.pubmed22584720
hcfmusp.origem.scieloSCIELO:S1807-59322012001300024
hcfmusp.origem.scopus2-s2.0-84863939224
hcfmusp.origem.wosWOS:000304082400024
hcfmusp.publisher.citySAO PAULO
hcfmusp.publisher.countryBRAZIL
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