The role of endoscopy and endoscopic ultrasonography in the diagnosis of gastrointestinal neuroendocrine tumors

Abstract

SUMMARY
Gastrointestinal neuroendocrine tumors are rare malignancies
that have been classified by the peptides they secrete
and the resulting clinical symptoms. They constitute less
than 2% of all gastrointestinal cancers. Fifty percent of
neuroendocrine tumors in clinical practice are the so-called
carcinoid variety and are found incidentally at operation,
after metastasis has occurred in the small intestine. Approximately
60% of pancreatic gastrinomas are concentrated
in an area sub-tented by the head of the pancreas, gastric
antrum, and first portion of the duodenum. The role of
endoscopic techniques (upper GI endoscopy, push enteroscopy,
and colonoscopy) in the diagnosis of endocrine
gastrointestinal tumors seems to be quite important. Although
there are no specific endoscopic features allowing
the accurate and safe endoscopic diagnosis of an endocrine
tumor, endoscopy could aid in the final diagnosis reached
by identifying and removing the lesion or taking biopsies
and sending them for histology. On the other hand,
endoscopic ultrasonography, in experienced hands, not only
visualizes the tumor itself but offers the ability to obtain
smears for cytologic examination via fine needle aspiration.
The invention of the wireless capsule which transfers high
quality endoscopic pictures of the whole small bowel, will
probably replace the classical small bowel barium followthrough
in patients with suspected small bowel endocrine
tumor.
Key words: Neuroendocrine tumors, Endoscopy, Gastrointestinal
hormones