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Suggest Treatment For Neuroendocrine Tumor Of Liver And Pancreas

Posted on Mon, 5 May 2014

Question: As I told you before, I was newly diagnosed with a neuroendocrine tumor. After an initial liver biopsy, the diagnosis was made. I had liver mets. I am under the care of an oncologist, and have had a pet scan, octreoscan, and have to have a second liver biopsy because they did not get enough tissue to tell the specific kind o neuroendocrine tumor. They saw a spot (very small ) on my pancreas but it did not light up on the octreoscan. They saw a 7mm area on my lower lung but it has not shown on either pet or octreoscan. I have read that along with chemo surgery to remove the primary in the pancreas is advised. What should my next consideration be since everyone seems focused on the liver? Very small mets scattered throughout. ) All I know so far is that this is low grade and slow growing. Thanks XXXXXXX

Answered by Dr. Vivek Chail (8 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi Thanks for writing in to us. All liver metastases from neuroendocrine tumors of pancreas (islet cell tumors) should be evaluated for possible surgical removal of the tumor. In case of big lesions in liver, if the tumor is confined to one or the other lobe of the liver then liver resection (liver removal) is indicated. Partial removal of the liver is an extremely safe operation today and the death rate from this procedure is less than 2% in major surgical centers that frequently perform this type of surgery. In small scattered tumors that you have, liver metastases from islet cell tumors are slow growing and the patient may live for many months to years after the diagnosis. A research in 70 patients with neuroendocrine tumors shows that pancreatic neuroendocrine tumors can be safely resected without mortality and with minimal morbidity. The presence of lymphovascular invasion can be used to classify neuroendocrine tumors as malignant, and this appears to predict survival. Patients with malignant tumors can expect long-term survival even in the setting of metastatic disease. Please read more on the research from link http://www.ncbi.nlm.nih.gov/pubmed/0000 Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar