Management of Neuroendocrine Tumors - Episode 1

Neuroendocrine Tumors: Introduction and Overview

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In the first installment of the series, the moderator, Matthew H. Kulke, MD, provides an overview and brief description of neuroendocrine tumors (NETs) and introduces the panel, which includes: Pamela L. Kunz, MD, Rodney F. Pommier, MD, and James C. Yao, MD.

Pommier describes the characteristics and types of NETs. Overall, two main distinctions exist, the first group is comprised of patients with pancreatic NETs and the second carcinoids, which includes NETs that arise in the lungs, kidneys, GI tract, and gonads.

There is a difference in both incidences and presentation between the two groups, Pommier notes. Carcinoid tumors appear in roughly 1 in 100,000 while pancreatic NETs occur in 1 in a million, per year. For presentation, approximately 80% with carcinoids have metastatic disease at diagnosis, whereas 60% to 65% of pancreatic NETs are metastatic. In general, Pommier notes, pancreatic NETs can be resected more readily than carcinoids.

Subgroups exist within each of these classifications, Yao notes. For example, colorectal carcinoid tumors are frequently found incidentally during a colonoscopy whereas small bowel carcinoid tumors are not usually diagnosed until symptomatic. Overall, the diagnosis varies depending on the primary location of the tumor.