- What are the different types of neuroendocrine tumors and how do they form?
Neuroendocrine tumors are rare, with only 2-4 cases per 100,000 people observed. Their cells produce hormones that act as their own growth factors. This process is known as autocrine growth. Their name comes from the origin of the cells, namely the nervous system. They are mainly found in the stomach, pancreas, small intestine, and large intestine. Different types are determined by the type of hormones they produce: insulinoma, carcinoid, gastrinoma, and glucagonoma.
- The specific symptoms of neuroendocrine tumors vary depending on the type of tumor and where it is located in the body. They can be caused by the tumor itself growing and pressing on nearby organs or by the tumor producing hormones. Some general symptoms that can occur with neuroendocrine tumors include: * **Abdominal pain:** This is a common symptom and can be constant or come and go. * **Diarrhea:** Often persistent and may be accompanied by abdominal cramps. * **Flushing:** Reddening of the skin, particularly on the face and neck, which may be accompanied by warmth and sweating. * **Wheezing and shortness of breath:** Can occur if the tumor is producing hormones that affect the airways. * **Skin changes:** Such as rashes or thickening of the skin. * **Fatigue or weakness:** A general feeling of being tired and lacking energy. * **Unexplained weight loss or gain:** Changes in body weight without trying. * **Nausea and vomiting:** Feeling sick to your stomach and throwing up. * **Heart murmurs or palpitations:** Unusual heart sounds or a feeling of a racing or fluttering heartbeat. * **High blood sugar (hyperglycemia) or low blood sugar (hypoglycemia):** Depending on the hormones the tumor is producing. **Tumor-Specific Symptoms:** * **Carcinoid tumors:** Often found in the digestive tract or lungs, these can cause flushing, diarrhea, abdominal pain, wheezing, and heart valve problems. * **Insulinomas:** Tumors of the pancreas that produce too much insulin, leading to dangerously low blood sugar levels (hypoglycemia). Symptoms include confusion, sweating, dizziness, shakiness, and fainting. * **Gastrinomas:** Tumors, often in the pancreas or duodenum, that produce too much gastrin. This leads to excessive stomach acid, causing severe stomach ulcers and abdominal pain. * **Glucagonomas:** Tumors of the pancreas that produce too much glucagon. This can cause a characteristic rash (necrolytic migratory erythema), weight loss, and high blood sugar. * **Somatostatinomas:** Tumors that produce too much somatostatin, which can inhibit the production of other hormones. Symptoms can include diarrhea, abdominal pain, and gallstones. * **VIPomas:** Tumors that produce vasoactive intestinal peptide (VIP). This can lead to watery diarrhea, low potassium levels, and low stomach acid. * **Paragangliomas/Pheochromocytomas:** Tumors of the adrenal glands or nerve cells. They produce too much adrenaline and noradrenaline, leading to episodes of high blood pressure, headaches, sweating, palpitations, and anxiety. It's important to note that these symptoms can also be caused by many other conditions. If you are experiencing any of these symptoms, it's crucial to consult a doctor for proper diagnosis and treatment.
It is important to always examine hormone production, as some neuroendocrine oncological diseases are non-hormone-producing. Hormone production plays a key role in choosing the right treatment. We most commonly recognize neuroendocrine tumors by the following symptoms: sweating, tachycardia, shortness of breath, diarrhea, and flushing.
- What is the diagnostic process?
In carcinoid tumors, hormone production is detected in serum according to serotonin and chromogranin A levels, as well as in urine according to 5-hydroxyindoleacetic acid concentration.
PET scans are performed for hormonally active tumors. Scans for carcinoids are called DOTATOC. They provide images of the cells that produce hormones.
- How are neuroendocrine tumors treated?
With the correct treatment, the patient's prognosis can be very good and long-term, as the cells of these tumors have slow and prolonged growth.
When we have a localized tumor, we can remove it through surgery. Invasive radiological techniques such as embolization are also used for tumors that have spread to the liver, for example.
During medical treatment, hormonal blockers are administered, which suppress the autocrine growth of neuroendocrine cells. Chemotherapy is also used.
