Diagnosis, Natural History, Management, tumor biology of Gastrinomas/PETs/Neuroendocrine tumors

National Institute Of Diabetes And Digestive And Kidney Diseases

Investigators

Linked publications, trials & patents

Abstract

Gastrinomas are the most common symptomatic, malignant pancreatic neuroendocrine tumor (pNETs) in patients with or without MEN1 and sufficient numbers of these patients have been entered into our protocols to allow systematic assessment from an extensive database. Furthermore, with various collaborators this information is often combined or compared to that in other pNETs/NET patients. A number of different collaborative guidelines/papers/studies involved in the analyses of major clinical problems in the management of gastrinomas and other pNETs /neuroendocrine tumors were recently completed. One of the principal areas of controversy in the longtime management of patients with Zollinger-Ellison syndrome (ZES)(gastrinomas)is how to successfully manage the acid hypersecretion. Because these patients have massive acid hypersecretion and are usually not cured by surgery they require life-long acid suppressive treatment. On of the controversial potential side effects is whether the patients can develop Vitamin B12 (VB12)deficiency as its absorption from food requires acid. Our recent study shows VB12 deficiency does occur in 20% of our patients and it is directly due to the acid suppressive effects of the drugs used. This is the first clear evidence that this possible side effect needs to be monitored for in these patients. Recently, using data from our database as well as the literature, a chapter on Neuroendocrine tumors was written with Prof E Wolin for the general medicine textbook, Goldman-Cecil Medicine as well as a general chapter on clinical manifestations of these tumors with Prof T Ito in a general textbook.