Clinical Characteristics and Management of Functional Pancreatic Neuroendocrine Neoplasms: A Single Institution 20-Year Experience with 286 Patients
Background. Functional pancreatic neuroendocrine neoplasms (PanNENs) are very rare disorders but have complex spectrum, including insulinoma, gastrinoma, glucagonoma, somatostatinoma, and VIPoma. Patients with PanNENs usually present with characteristic symptoms caused by corresponding hormone hyper...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2020/1030518 |
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| author | Yuqing Qu Haoming Li Xianling Wang Yulong Chen Qinghua Guo Yu Pei Jin Du Jingtao Dou Jianming Ba Zhaohui Lv Yiming Mu |
| author_facet | Yuqing Qu Haoming Li Xianling Wang Yulong Chen Qinghua Guo Yu Pei Jin Du Jingtao Dou Jianming Ba Zhaohui Lv Yiming Mu |
| author_sort | Yuqing Qu |
| collection | DOAJ |
| description | Background. Functional pancreatic neuroendocrine neoplasms (PanNENs) are very rare disorders but have complex spectrum, including insulinoma, gastrinoma, glucagonoma, somatostatinoma, and VIPoma. Patients with PanNENs usually present with characteristic symptoms caused by corresponding hormone hypersecretion. It has always been challenging in dealing with such rare but complicated disorders. In this report, we analyzed the clinical characteristics of functional PanNENs in a large cohort of Chinese patients and summarized our clinical experience in diagnosis and treatment. Methods. The retrospective analysis was performed in patients with a definite diagnosis of functional PanNENs hospitalized in Chinese PLA General Hospital between 2000 and 2020. The clinical characteristics, surgical information, and pathological findings were extracted from their medical records and were analyzed. Results. Totally, 286 patients (gender: male 103 and female 183; age: 45.55 ± 15.23 years old) were diagnosed with definite functional PanNENs. The most frequent functional PanNENs were insulinoma (266/286) followed by glucagonoma (10/286), somatostatinoma (3/286), adrenocorticotropic hormone- (ACTH-) producing tumor (3/286), gastrinoma (2/286), and VIPoma (2/286). Nine patients were diagnosed with multiple endocrine neoplasia type 1 (MEN1) in which all the associated functional PanNENs were insulinomas. The duration from symptoms’ onset to confirmed diagnosis was 3.67 ± 4.28 years. Two hundred and eighty patients with tumor localized in pancreatic or with limited metastasis underwent surgery. The symptoms associated with hormonal oversecretion were improved significantly after surgery. Five patients with unresectable metastases or tumor recurrence after surgery were administrated with systemic chemotherapy or other targeted therapies. With these various therapies, the symptoms were also partially relieved. According to findings in pathological and immunochemical examination, all the functional PanNENs were categorized into NEN-G1 (41.95%), NEN-G2 (54.90%), NEN-G3 (3.15%), and NEC-G3 (0%). Conclusion. Patients with suspected functional PanNENs should have a systematic endocrine examination at diagnosis. Multidisciplinary collaborations are essential for precise diagnosis and tumor localization. A successful surgery or other targeted therapies can improve the prognosis of patients with such rare but complex disorders. |
| format | Article |
| id | doaj-art-36e432824e244d94a3846d66bd014f1d |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-36e432824e244d94a3846d66bd014f1d2025-02-03T01:28:25ZengWileyInternational Journal of Endocrinology1687-83371687-83452020-01-01202010.1155/2020/10305181030518Clinical Characteristics and Management of Functional Pancreatic Neuroendocrine Neoplasms: A Single Institution 20-Year Experience with 286 PatientsYuqing Qu0Haoming Li1Xianling Wang2Yulong Chen3Qinghua Guo4Yu Pei5Jin Du6Jingtao Dou7Jianming Ba8Zhaohui Lv9Yiming Mu10Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Endocrinology, Chinese PLA General Hospital, Beijing 100853, ChinaBackground. Functional pancreatic neuroendocrine neoplasms (PanNENs) are very rare disorders but have complex spectrum, including insulinoma, gastrinoma, glucagonoma, somatostatinoma, and VIPoma. Patients with PanNENs usually present with characteristic symptoms caused by corresponding hormone hypersecretion. It has always been challenging in dealing with such rare but complicated disorders. In this report, we analyzed the clinical characteristics of functional PanNENs in a large cohort of Chinese patients and summarized our clinical experience in diagnosis and treatment. Methods. The retrospective analysis was performed in patients with a definite diagnosis of functional PanNENs hospitalized in Chinese PLA General Hospital between 2000 and 2020. The clinical characteristics, surgical information, and pathological findings were extracted from their medical records and were analyzed. Results. Totally, 286 patients (gender: male 103 and female 183; age: 45.55 ± 15.23 years old) were diagnosed with definite functional PanNENs. The most frequent functional PanNENs were insulinoma (266/286) followed by glucagonoma (10/286), somatostatinoma (3/286), adrenocorticotropic hormone- (ACTH-) producing tumor (3/286), gastrinoma (2/286), and VIPoma (2/286). Nine patients were diagnosed with multiple endocrine neoplasia type 1 (MEN1) in which all the associated functional PanNENs were insulinomas. The duration from symptoms’ onset to confirmed diagnosis was 3.67 ± 4.28 years. Two hundred and eighty patients with tumor localized in pancreatic or with limited metastasis underwent surgery. The symptoms associated with hormonal oversecretion were improved significantly after surgery. Five patients with unresectable metastases or tumor recurrence after surgery were administrated with systemic chemotherapy or other targeted therapies. With these various therapies, the symptoms were also partially relieved. According to findings in pathological and immunochemical examination, all the functional PanNENs were categorized into NEN-G1 (41.95%), NEN-G2 (54.90%), NEN-G3 (3.15%), and NEC-G3 (0%). Conclusion. Patients with suspected functional PanNENs should have a systematic endocrine examination at diagnosis. Multidisciplinary collaborations are essential for precise diagnosis and tumor localization. A successful surgery or other targeted therapies can improve the prognosis of patients with such rare but complex disorders.http://dx.doi.org/10.1155/2020/1030518 |
| spellingShingle | Yuqing Qu Haoming Li Xianling Wang Yulong Chen Qinghua Guo Yu Pei Jin Du Jingtao Dou Jianming Ba Zhaohui Lv Yiming Mu Clinical Characteristics and Management of Functional Pancreatic Neuroendocrine Neoplasms: A Single Institution 20-Year Experience with 286 Patients International Journal of Endocrinology |
| title | Clinical Characteristics and Management of Functional Pancreatic Neuroendocrine Neoplasms: A Single Institution 20-Year Experience with 286 Patients |
| title_full | Clinical Characteristics and Management of Functional Pancreatic Neuroendocrine Neoplasms: A Single Institution 20-Year Experience with 286 Patients |
| title_fullStr | Clinical Characteristics and Management of Functional Pancreatic Neuroendocrine Neoplasms: A Single Institution 20-Year Experience with 286 Patients |
| title_full_unstemmed | Clinical Characteristics and Management of Functional Pancreatic Neuroendocrine Neoplasms: A Single Institution 20-Year Experience with 286 Patients |
| title_short | Clinical Characteristics and Management of Functional Pancreatic Neuroendocrine Neoplasms: A Single Institution 20-Year Experience with 286 Patients |
| title_sort | clinical characteristics and management of functional pancreatic neuroendocrine neoplasms a single institution 20 year experience with 286 patients |
| url | http://dx.doi.org/10.1155/2020/1030518 |
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