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Diagnostic pitfalls in digestive neuroendocrine tumours

Journal Volume 72 - 2009
Issue Fasc.1 - Case series
Author(s) I. Borbath, F. Jamar, T. Delaunoit, P. Demetter, G. Demolin, A. Hendlisz, P. Pattyn, M. Peeters, G. Roeyen, E. Van Cutsem, Ph. Van Hootegem, J.L. Van Laethem, C. Verslype, S. Pauwels
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(1) Department of Gastroenterology, Cliniques Universitaires Saint-Luc, Brussels ; (2) Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Brussels ; (3) Department of Gastroenterology and Medical Oncology, Jolimont Hospital, Haine-St-Paul ; (4) Department of Pathology, Erasme University Hospital, Anderlecht ; (5) Department of Gastroenterology and Oncology, C.H.C. St. Joseph, Liège ; (6) Medical Oncology Clinic, Institut Jules Bordet, Brussels ; (7) Department of Gastrointestinal Surgery, University Hospital Gent, Gent ; (8) Department of Gastroenterology, University Hospital Gent, Gent ; (9) Department of Hepatobiliary, Endocrine and Transplantation Surgery, University Hospital Antwerp, Edegem ; (10) Department of Digestive Oncology, University Hospital Gasthuisberg, Leuven ; (11) Department of Internal Medicine and Gastroenterology, St. Lucas Hospital, Brugge ; (12) Department of Gastroenterology, Gastrointestinal Oncology Unit, Erasme University Hospital, Anderlecht ; (13) Department of Hepatology and Digestive Oncology, University Hospital Gasthuisberg, Leuven.

Gastro-entero-pancreatic neuroendocrine tumours (GEP NET) represent a rare and highly heterogeneous entity that often is revealed by vague and non-specific symptoms, leading to a delayed diagnosis. Here we will review some of the most regularly observed false positive and false negative cases and provide clues to recog- nize and manage them properly. Particularly, the value of chromo- granin-A as a serum tumour marker and Somatostatin receptor scintigraphy as an imaging test, are reviewed. Indeed, chromo- granin-A and other hormones, such as gastrin, as well as urinary 5- hydroxy-indolic acetic acid (5-HIAA) are often tested to diagnose NET without appraising the clinical situation, leading to extensive work-up on false bases. On the other hand, some tests are per- formed in situations where they do not add additional information (e.g. 5-HIAA in pancreatic or rectal NET) because invariably negative. Somatostatin receptor scintigraphy is an expensive examination, still not reimbursed in Belgium, for which indications must be carefully assessed, knowing its specificity and sensitivity. (Acta gastroenterol. belg., 2009, 72, 29-33).

© Acta Gastro-Enterologica Belgica.
PMID 19402368