Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- profuse watery diarrhea
Outros fatores diagnósticos
- age around 50 years
- headache
- weight loss
- poor skin turgor
- dry mucus membranes
- muscle weakness
- muscle cramps
- gastrointestinal symptoms
- hyperglycemia symptoms
- flushing
- hepatomegaly
- history of multiple endocrine neoplasia type 1 (MEN1)
Fatores de risco
- multiple endocrine neoplasia type 1 (MEN1)
- age around 50 years
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- serum potassium
- serum bicarbonate
- serum calcium
- serum glucose
- vasoactive intestinal peptide (VIP) radioimmunoassay
- liver function tests
Investigações a serem consideradas
- arterial blood gas analysis
- gastric pH monitoring
- chromogranin A
- pancreatic polypeptide
- contrast-enhanced CT scan of abdomen
- contrast-enhanced MRI of abdomen
- somatostatin receptor PET-CT/MRI
- somatostatin receptor scintigraphy
- endoscopic ultrasound
- operative exploration
- intraoperative ultrasound
- biopsy
Algoritmo de tratamento
initial presentation of symptomatic patient
localized disease
metastatic disease: surgical candidate
metastatic disease: nonsurgical candidate
refractory disease
Colaboradores
Autores
Harish Lavu, MD, FACS
Professor of Surgery
Sidney Kimmel Medical College
Thomas Jefferson University
Philadelphia
PA
Declarações
HL declares that he has no competing interests.
Charles J. Yeo, MD, FACS
The Samuel D. Gross Professor and Chair
Department of Surgery
Sidney Kimmel Medical College
Thomas Jefferson University
Philadelphia
PA
Divulgaciones
CJY declares that he has no competing interests.
Revisores por pares
Alexandria Phan, MD
Professor of Medicine
Froedtert Hospital and the Medical College of Wisconsin
Milwaukee
WI
Divulgaciones
AP declares that she has no competing interests.
Jonathan Strosberg, MD
Professor
Moffitt Cancer Center
Tampa
FL
Divulgaciones
JS has consulted for Novartis and serves on the Speakers’ Bureau for Ipsen.
Jaime Ruiz-Tovar, MD
Fellow of the Spanish Association of Surgeons (AEC)
Department of Surgery
University Hospital Ramon y Cajal
Madrid
Spain
Divulgaciones
JRT declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: neuroendocrine and adrenal tumors [internet publication].Texto completo
Hofland J, Falconi M, Christ E, et al. European Neuroendocrine Tumor Society 2023 guidance paper for functioning pancreatic neuroendocrine tumour syndromes. J Neuroendocrinol. 2023 Aug;35(8):e13318.Texto completo Resumen
Pavel M, Öberg K, Falconi M, et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 Jul;31(7):844-60.Texto completo
Del Rivero J, Perez K, Kennedy EB, et al. Systemic therapy for tumor control in metastatic well-differentiated gastroenteropancreatic neuroendocrine tumors: ASCO guideline. J Clin Oncol. 2023 Nov 10;41(32):5049-67.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Infectious gastroenteritis
- Osmotic diarrhea
- Ileal bile acid malabsorption
Más DiferencialesGuías de práctica clínica
- NCCN clinical practice guidelines in oncology: neuroendocrine and adrenal tumors
- Symptom management for well-differentiated gastroenteropancreatic neuroendocrine tumors: ASCO guideline
Más Guías de práctica clínicaFolletos para el paciente
Diarrhea in children
Más Folletos para el paciente
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