skip to main content

    Updated Visitor Guidelines

 

MENU

 

Gastrointestinal Neuroendocrine Tumors

Gastrointestinal (GI) neuroendocrine tumors (NETs) arise from neuroendocrine cells that are present in our GI organs and responsible for secretion of many chemicals and hormones responsible for control of that organ as well as other distant organs.

These tumors are rare and occur in only about 2 of every 100,000 people. The management of GI-NETs depends on the following:

  • Location of the primary tumor. The management may vary based on whether the tumor originated from the stomach, intestines, liver or gallbladder.
  • Functional status. If the tumors over-produce a specific hormone that is causing symptoms related to the over production of that hormone, then it is a functionally active tumor. Majority of the GI-NET's are not functionally active.
  • Tumor grade. The grade (1-3) of the GI-NET is determined by our colleagues in Pathology based on the differentiation status (that is, how mature are the tumor cells), expression of the Ki-67 protein and the number of actively dividing cells (mitotic rate).

If the GI-NET arises from the small bowel (mid gut), then it is often referred to as a Carcinoid Tumor. Carcinoid tumors may sometimes over produce the serotonin hormone.

In high levels this hormone can cause flushing and redness of the skin of the face, neck and upper chest which may last for several minutes. Patients with Carcinoid Syndrome may also develop diarrhea, heart valve problems, wheezing and abdominal pain or intestinal obstruction.

Diagnosis

The diagnosis of a carcinoid GI-NET may require:

  • Anatomic scans (CT or MR scans)
  • Functional scans (PET-CT DOTATATE scan)
  • Blood (routine blood test and hormone levels)
  • Urine (24 hour 5-HIAA)

     

Treatment of GI Neuroendocrine Tumors.

The management of GI-NET depends on the following:

  • Location of the primary tumor
  • Functional status
  • Tumor grade
  • Staging
  • Symptoms

Surgical removal of the tumor involving the intestines often requires resection of intestine.

In patients where the tumor which has spread to the liver, surgical resection of part of the liver or other treatments to destroy these tumors may help to decrease the amount of hormone produced and thus improve symptoms.

In addition to surgery, there are several treatment options available for patients with GI-NETs, including somatostatin analogues, small molecule inhibitors, chemotherapy, targeted radiation / PRRT, liver directed therapy and clinical trials with novel drugs.

There is wide spectrum of carcinoid GI NET's and the prognosis for patients is very dependent on how early the tumor is treated. In very small, early tumors the cure rates are excellent, while in more advanced cases control of tumor and symptoms can be obtained with a combination of medical and surgical treatments.

At the Rogel Cancer Center, our experienced team of medical oncologists, surgeons, pathologists, endocrinologists, radiation oncologists, interventional radiologists come together to diagnose and treat these tumors.

Make an appointment or refer a patient

Patients are seen at the Rogel Cancer Center (maps and directions) and can get the process started by calling 734-647-8902. If you’re a health care provider, please call 800-962-3555.