Abordaje quirúrgico de los tumores neuroendocrinos pancreáticos

Surgical approach to Pancreatic Neuroendocrine Tumors

Palabras clave: páncreas, tumor neuroendocrino, pancreatectomía, tumores gastroenteropancreaticos

Resumen

Los tumores neuroendocrinos (TNEs) constituyen un grupo heterogéneo de neoplasias que se originan a partir de células neuroendocrinas. Son tumores poco frecuentes con un índice de detección estimado < 1/100,000 individuos, lo que corresponde al 1-2% de las neoplasias pancreáticas. La mayoría de los TNEP son esporádicos, pero estos pueden estar asociados a síndromes hereditarios, incluyendo la neoplasia endocrina múltiple de tipo 1 (NEM-1), el síndrome de Von Hippel Lindau, neurofibromatosis de tipo I y la esclerosis tuberosa. Entre 50 y 75 % de los tumores neuroendocrinos de páncreas pueden no ser funcionales y suelen tener una presentación tardía con síntomas inespecíficos. Tienen un comportamiento biológico menos agresivo que otras neoplasias pancreáticas, como el adenocarcinoma ductal; sin embargo, tienen un pronóstico menos favorable que los otros tumores neuroendocrinos del sistema  gastrointestinal. Se clasifican según el tipo histológico en 3 categorías, y según la producción de sustancias biológicamente activas en funcionantes y no funcionantes. El mejor tratamiento es la cirugía, siempre que el tumor sea resecable y es fundamental el diagnostico preoperatorio de la ubicación de la lesión mediante los estudios de imágenes para determinar el tipo de cirugía y el pronóstico del paciente.

Descargas

La descarga de datos todavía no está disponible.

Biografía del autor/a

Adel Al Awad Jibara, Universidad de Zulia, Venezuela. Maracaibo, Venezuela

Escuela de Medicina. Facultad de Medicina, Universidad de Zulia, Venezuela. Maracaibo, Venezuela

Alfredo José Ramírez, Universidad de los Andes. Mérida, Venezuela.

Facultad de Medicina. Universidad de los Andes. Mérida, Venezuela.

Vianny G. Valera García, Hospital General de Cabimas Dr. Adolfo D ́Empaire, Cabimas, Venezuela.

Hospital General de Cabimas Dr. Adolfo D ́Empaire, Cabimas, Venezuela.

Citas

Lubrasch . Ueber den prim ren rebs des Ileum, nebst emer ungen ber das gleichzeitige Vorkommen von Krebs und Tuberkolose. Virchows Arch. 1888; 111: 280- 317

Halperin D. Neuroendocrine Tumors. En: Kantarjian H, Wolff R, editors. The MD Anderson Manual of Medical Oncology. Third edition. New York: The McGraw-Hill Companies, Inc; 2016

Dasari A, Shen C, Halperin D, Zhao B, Zhou S, Xu Y. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol. 2017;77030:1-8.

Wilder RM, Allan FN, Power WH, et al. Carcinoma of the islands of the pancreas: Hiperinsulinism and hypoglycemia. JAMA. 1927;89:348-55.

Kulke MH, Anthony LB, Bushnell DL, et al. NANETS treatment guidelines: Well- differentiated neuroendocrine tumors of the stomach and pancreas. Pancreas. 2010;39:735-52.

Metz DC, Robert T. Gastrointestinal neuroendocrine tumors: Pancreatic endocrine tumors. Gastroenterology. 2008;135:1469-92

Chiruvella A, Kooby DA. Surgical management of pancreatic neuroendocrine tumors. Surg Oncol Clin N Am. 2016;25:401-21.

Tamm EP, Bhosale P, Lee JH, Rohren EM. State-of-the-art imaging of pancreatic neuroendocrine tumors. Surg Oncol Clin N Am. 2016;25:375-400.

Modlin M, Lye KD. A 5-decade analysis of 13715 carcinoid tumors. Cancer 2003;97:934-59.

Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26:3063-72

Reid MD, Balci S, Saka B, Adsay NV. Neuroendocrine tumors of the pancreas: Current concepts and controversies. Endocr Pathol. 2014;25:65-79.

Lloyd RV, Osamura RY, Klöppel GRJ, editores. WHO Classification of Tumours of Endocrine Organs. WHO/ IARC Classification of Tumours. 4th ed. Lyon: IARC Press. 2017; 355.

Klöppel G. Classification and pathology of gastroenteropancreatic neuroendocrine neoplasms. Endocr Relat Cancer 2011; 18 (1): 1-16.

Guettier JM, Kam A, Chang R, Skarulis MC, Cochran C, Alexander HR, et al. Localization of insulinomas to regions of the pancreas by intraarterial calcium stimulation: the NIH experience. J Clin Endocrinol Metab. 2009; 94: 1074-1080.

Gorelik M, Ahmad M, Grossman D, Grossman M, Cooperman AM. Nonfunctioning Incidental Pancreatic Neuroendocrine Tumors: Who, When, and How to Treat? Surg Clin North Am. 2018;98(1):157-67.

Mathur A, Gorden P, Libutti SK. Insulinoma. Surg Clin North Am. 2009;89(5):1105- 21.

Marchegiani G, Crippa S, Malleo G, Partelli S, Capelli P, Pederzoli P, et al. Surgical treatment of pancreatic tumors in childhood and adolescence: uncommon neoplasms with favorable outcome. Pancreatol Off J Int Assoc Pancreatol IAP Al. 2011;11(4):383- 9.

Martín Pérez E, Sabater Ortí L, Sánchez-Bueno F, editores. Cirugía Biliopancreática. Guías clínicas de la Asociación Española de Cirujanos. 2da edición. Madrid: Arán; 2018.

Rodríguez L, Nazario F. Insulinoma: presentación neuro psiquiátrica, caso clínico y revisión de la literatura. Rev. Med. Clin. Condes - 2022; 33(1) 96-99 de Herder WW, Zandee WT, Hofland J. Insulinoma. [Updated 2020 Oct 25]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. https://www.ncbi.nlm.nih.gov/sites/books/NBK278981/

Hernández Mateo P, Martín Lores I, Gómez Cáceres P, Lannegrand Menéndez B, Galván Herráez L, Matute Teresa F. Tumores neuroendocrinos pancreáticos.: Semiología en TC y RM. seram [Internet]. https://piper.espacio- seram.com/index.php/seram/article/view/2455

Tucker ON, Crotty PL, Conlon KC. The management of insulinoma. Br J Surg 2006; 93: 264-75.

Wiesli P, Brändle M, Schmid C, Krähenbühl L, Furrer J. Selective arterial calcium stimulation and hepatic venous sampling in the evaluation of hyperinsulinemic hypoglycemia: Potential and limitations. J Vasc Interv Radiol. 2004;15:1251-6.

Grants CS. Insulinoma. Surg Oncol Clin North Am 1998; 7: 819-44

Falconi M, Eriksson B, Kaltsas G, Bartsch D, Capdevila J, Caplin M, et al. Consensus guidelines update for the management of functional p-NETs (F-p- NETs) and non - functional p-NETs (NF-p-NETs). Neuroendocrinology. 2016;103(2):153-171.

Fernández-Cruz L, Blanco L, Cosa R, Rendón H. Is laparoscopic resection adequate in patients with neuroendocrine pancreatic tumors? World J Surg. 2008;32(5):904-17.

Berrospi Espinoza Francisco, Celis Zapata Juan, Ruiz Figueroa Eloy, Chavez Passiuri Iván, Reaño Gustavo. Localización de Insulinoma Pancreático con Ultrasonografía Laparoscópica. Rev. gastroenterol. Perú [Internet]. 2007;27(1): 91-94. http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1022-
51292007000100013&lng=es.

Gimm O, König E, Thanh PN et al. Intra-operative quick insulin assay to confirm complete resection of insulinomas guided by selective arterial calcium injection (SACI). Langenbecks Arch Surg 2007; 392: 679–684.

Amikura K, Nakamura R, Arai K et al. Role of intraoperative insulin monitoring in surgical management of insulinoma. J Laparoendosc Adv Surg Tech A 2001; 11: 193– 199.

Proye C, Pattou F, Carnaille B et al. Intraoperative insulin measurement during surgical management of insulinomas. World J Surg 1998; 22: 1218–1224.

Carneiro DM, Levi JU, Irvin GL 3rd. Rapid insulin assay for intraoperative confirmation of complete resection of insulinomas. Surgery 2002; 132: 937–943.

Shin JJ, Gorden P, Libutti SK. Insulinoma: pathophysiology, localization and management. Future Oncol. 2010;6(2):229–237 Zhao YP, Zhan HX, Zhang TP, et al. Surgical management of patients with insulinomas: Result of 292 cases in a single institution. J Surg Oncol. 2011;103(2):169–174.

Danforth DN Jr, Gorden P, Brennan MF. Metastatic insulin-secreting carcinoma of the pancreas: clinical course and the role of surgery. Surgery 1984;96: 1027– 1037.

Thompson GB, van Heerden JA, Grant CS, Carney JA, Ilstrup DM. Islet cell carcinomas of the pancreas: a twenty-year experience. Surgery 1988;104: 1011-1017.

Sarmiento JM, Que FG. Hepatic surgery for metastases from neuroendocrine tumors. Surg Oncol Clin N Am 2003;12: 231–242.

Anderson, C. W., & Bennett, J. J. (2016). Clinical Presentation and Diagnosis of Pancreatic Neuroendocrine Tumors. Surgical Oncology Clinics of North America, 25(2), 363–374.

Grozinsky-Glasberg S, Mazeh H, Gross DJ. Clinical features of pancreatic neuroendocrine tumors. J Hepatobiliary Pancreat Sci 2015;22(8):578–85

Jensen RT. Endocrine tumors of the gastrointestinal tract and pancreas. In: Harrison´s Principles of Internal Medicine. 19th edition. New York: The McGraw- Hill Companies, Inc.; 2015.

Fottner C, Ferrata M¸ Weber M. Hormone secreting gastro-entero-pancreatic neuroendocrine neoplasias (GEP-NEN): When to consider, how to diagnose? Rev Endocr Metab Disord 2017; 18: 393-410.

Moreno García, Santiago, Andrea Carolina Caicedo Durán, Natalia LosadaTrujillo, y Erwin Jaime García González. «Gastrinoma. Revisión de tema». Morfolia 10, no. 1 (enero 1, 2018): 10–26. Accedido febrero 14, 2022. https://revistas.unal.edu.co/index.php/morfolia/article/view/72245.

Pérez Saus DI, Caldevilla Bernardo DD, Pastor Juan DMR, Donoso Esteban DI, Giraldo Alfaro DG, Campos Pérez DM. NEUROENDOCRINAMENTE: LO QUE EL RADIÓLOGO DEBE SABER ACERCA DE LOS TUMORES NEUROENDOCRINOS. seram [Internet]. 021;1(1). https://piper.espacio- seram.com/index.php/seram/article/view/4050

Partelli, S., Maurizi, A., Tamburrino, D., Baldoni, A., Polenta, V., Crippa, S., & Falconi, M. (2014). GEP-NETS UPDATE: A review on surgery of gastro-entero- pancreatic neuroendocrine tumors. European Journal of Endocrinology, 171(4), R153–R162.

Beltrán MA. Síndrome de Zollinger-Ellison: revisión del conocimiento actual. Rev Colomb Cir. 2016;31:197-211

Vargas C, Castaño R. Tumores neuroendocrinos gastropancreáticos, Artículo de revisión. Rev Col Gastroenterol / 25 (2) 2010.

Moreno S, Caicedo A, Trujillo N, García E. Gastrinoma. Revisión de tema. Morfolia–Vol. 10–No1-2018

Sarr MG, Murr M, Smyrk TC, Yeo CJ, Fernández-del-Castillo C, Hawes RH, Freeny PC. Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions. J Gastrointest Surgí. 2003;7(3):417-28.

Kindmark H, Sundin A, Granberg D, et al. Endocrine pancreatictumors with glucagon hypersecretion: a retrospective study of 23 cases during 20 years. Med Oncol 2007; 24: 330-337

Akirov A, Larouche V, Alshehri S, Asa SL, Ezzat S. Treatment Options for Pancreatic Neuroendocrine Tumors. Cancers (Basel) 2019; 11(6): E828.

Shah M, Goldner W, Halfdanarson T, Bergsland E, Berlin J, Halperin D, Chan J, Kulke M, Benson A, Blaszkowsky L, et al. NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine and Adrenal Tumors. J Natl Compr Cancer Netw 2018; 16: 693-702.

Metz DC, Jensen RT. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology 2008;135:1469–92

Jensen RT, Norton JA. Endocrine tumors of the pancreas and gastrointestinal tract. In: Feldman M, Friedman LS, randt LJ, editors. Sleisenger and Fordtran’s gastrointestinal and liver disease. Philadelphia: Saunders; 2010. p. 491–522.

Verner JV, Morrison AB. Islet cell tumor and a syndrome of refractory watery diarrhea and hypokalemia. Am J Med. 1958;25(3):374-80.

de Herder WW, Rehfeld JF, Kidd M, Modlin IM. A short history of neuroendocrine tumours and their peptide hormones. Best Pract Res Clin Endocrinol Metab. 2016;30(1):3-17

Chen C, Zheng Z, Li B, Zhou L, Pang J, Wu W, et al. Pancreat-ic VIPomas from China: Case reports and literature review. Pancreatology. 2019;19(1):44-9

House MG, Yeo CJ, Schulick RD. Periampullary pancreatic somatostatinoma. Ann Surg Oncol 2002;9:869–74.

Nesi G, Marcucci T, Rubio CA, et al. Somatostatinoma: clinico-pathological features of three cases and literature reviewed. J Gastroenterol Hepatol 2008;23: 521–6.

Jensen RT, Berna MJ, Bingham DB, et al. Inherited pancreatic endocrine tumor syndromes: advances in molecular pathogenesis, diagnosis, management, and controversies. Cancer 2008;113:1807–43.

Waisberg J, de Matos LL, Dos Santos HV, et al. Pancreatic carcinoid: a rare cause of diarrheogenic syndrome. Clinics (Sao Paulo) 2006;61:175–8.

Mao C, El Attar A, Domenico DR, et al. Carcinoid tumors of the pancreas. Status report based on two cases and review of the world’s literature. Int J Pancreatol 1998;23:153–64.

Guzmán Y, López R, Vera A, González-Devia D. Herramientas para el abordaje diagnóstico de los tumores neuroendocrinos de páncreas. Rev Colomb Cir. 2018;33:79-99

Bettini R, Partelli S, Boninsegna L, Capelli P, Crippa S, Pederzoli P, et al. Tumor size correlates with malignancy in nonfunctioning pancreatic endocrine tumor. Surgery. 2011;150:75–82.

de Herder WW. Biochemistry of neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab 2007;21:33–41.

Nobels FR, Kwekkeboom DJ, Coopmans W, et al. Chromogranin A as serum marker for neuroendocrine neoplasia: comparison with neuron-specific enolase and the alpha-subunit of glycoprotein hormones. J Clin Endocrinol Metab 1997;82:2622–8.

Campana D, Nori F, Piscitelli L, et al. Chromogranin A: is it a useful marker of neuroendocrine tumors? J Clin Oncol 2007;25:1967–73.

Zatelli MC, Torta M, Leon A, et al. Chromogranin A as a marker of neuroendocrine neoplasia: an Italian Multicenter Study. Endocr Relat Cancer 2007;14: 473–82.

Baudin E. Gastroenteropancreatic endocrine tumors: clinical characterization before therapy. Nat Clin Pract Endocrinol Metab 2007;3:228–39.

Hill JS, McPhee JT, McDade TP, Zhou Z, Sullivan ME, Whalen GF, et al. Pancreatic neuroendocrine tumors: The impact of surgical resection on survival. Cancer. 2009;115:741–51.

Gratian L, Pura J, Dinan M, Roman S, Reed S, Sosa JA. Impact of extent of surgery on survival in patients with small nonfunctional pancreatic neuroendocrine tumors in the United States. Ann Surg Oncol. 2014;11:3514–21.
Publicado
2022-10-25
Cómo citar
Al Awad Jibara, A., Ramírez, A. J., & Valera García, V. G. (2022). Abordaje quirúrgico de los tumores neuroendocrinos pancreáticos: Surgical approach to Pancreatic Neuroendocrine Tumors. Revista Profesional HígadoSano, (24), 32-46. https://doi.org/10.5281/zenodo.7516212
Sección
Artículos