Diffuse and focal sources of hyperinsulinism

Surgical treatment of carcinoids and endocrine pancreatic tumours

The common association of neuroendocrine abdominal neoplasms, carcinoids and endocrine pancreatic tumours, with often severe endocrine symptoms has justified considerable efforts to improve treatment in these conditions. Surgery still constitutes the principle therapy for the majority of these tumours. However, the introduction of new means of medical treatment with cytostatic agents, or more recently interferon and a somatostatin analogue, seem to have impact on indications and the extent of surgery in malignant forms of these tumours. It is thus probable that a surgical tumour reduction will increase the possibilities to achieve positive effects of the medical treatment even in advanced malignancies. However, the existence of an alternative medical therapy has increased obligations that surgery should be performed without morbidity or mortality.