Moot points of diagnosis and treatment of hormone-producing neuroendocrine tumors of pancreas

摘要

Based on literature data and own experience of treatment of 225 patients with neuroendocrine tumors (NET) authors discuss moot points of diagnosis and treatment of this severe category of patients. It is demonstrated that the most appropriate algorithm of diagnosis before surgery is the combination of US with endoscopic US and angiography. Intraoperative diagnosis must be performed with intraoperative US and endoscopic transillumination. Authors demonstrate positive results of staged surgical treatment of MEN-1 syndrome. Malignant NET with distant metastases is not contraindication for surgical treatment. This situation is indication either for radical surgery with excision of all metastases or for cytoreductive surgery with subsequent chemoembolization and chemotherapy.