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Neuroendocrine Tumor (NET) Diagnosis: Comprehensive Evaluation

Heterogeneous group of neoplasms arising from neuroendocrine cells with diverse clinical presentations

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Neuroendocrine Tumor (NET) Diagnosis: Comprehensive Evaluation?

Neuroendocrine tumors comprise heterogeneous group with cells of origin in neuroendocrine system including chromaffin cells, enterochromaffin cells, islet cells and others.

Common primary sites include small intestine, pancreas, lung, appendix, rectum and unknown primary in some cases.

Functional NETs produce hormones causing characteristic clinical syndromes including carcinoid syndrome, Zollinger-Ellison syndrome, insulinoma and others.

Non-functional NETs present with mass effect, incidental finding or metastatic disease without hormonal symptoms.

WHO grading system based on Ki-67 proliferation index and mitotic count categorizes tumors as G1, G2 or G3.

Symptoms

Carcinoid syndrome with flushing, diarrhea, bronchospasm and right-sided cardiac valvular disease in functional NETs with hepatic metastases.
Zollinger-Ellison syndrome with severe peptic ulcer disease and diarrhea in gastrinomas.
Insulinoma symptoms with hypoglycemia, neuroglycopenic symptoms and Whipple's triad.
Glucagonoma syndrome with necrolytic migratory erythema, diabetes and weight loss.
Local symptoms from primary tumor including abdominal pain, bowel obstruction or bleeding.

Risk Factors

Multiple endocrine neoplasia type 1 (MEN1) with germline mutations and familial NET predisposition.
Von Hippel-Lindau syndrome with pancreatic NETs and pheochromocytomas.
Neurofibromatosis type 1 with carcinoid tumors and other neuroendocrine neoplasms.
Tuberous sclerosis complex with pancreatic NETs and other neoplasms.
Sporadic NETs without identified hereditary syndrome accounting for majority of cases.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent flushing, persistent diarrhea or right heart failure symptoms warrant evaluation for carcinoid syndrome.
  • Severe peptic ulcer disease, especially with multiple ulcers or atypical locations, requires evaluation for gastrinoma.
  • Hypoglycemic symptoms with documented hypoglycemia require evaluation for insulinoma.
  • Family history of NETs or hereditary cancer syndromes warrants genetic counseling and screening.
  • Incidental imaging findings of pancreatic, intestinal or lung masses require comprehensive evaluation.

Treatment Methods

01
Comprehensive biochemical evaluation including chromogranin A, urinary 5-HIAA for carcinoid, hormone-specific testing for functional tumors.
02
Advanced imaging including somatostatin receptor scintigraphy with 68Ga-DOTATATE PET/CT, MRI for liver evaluation and CT scans.
03
Histopathologic diagnosis with biopsy or surgical specimen including immunohistochemistry, Ki-67 proliferation index and grading.
04
Genetic counseling for hereditary syndromes with germline testing as indicated.
05
Multidisciplinary tumor board review to integrate clinical, biochemical, imaging and pathologic findings, with subsequent treatment planning incorporating surgery, somatostatin analogs, peptide receptor radionuclide therapy, targeted therapy and other modalities optimizes outcomes for these heterogeneous tumors.

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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