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Sandru F, Carsote M, Valea A, Albu SE, Petca RC, Dumitrascu MC. Somatostatinoma: Beyond neurofibromatosis type 1 (Review). Exp Ther Med 2020; 20:3383-3388. [PMID: 32905002 DOI: 10.3892/etm.2020.8965] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023] Open
Abstract
Somatostatinoma is a tumour mainly originating from pancreas or duodenum; overall with an incidence of 1/40 million persons. We introduce a narrative review of literature of somatostatinoma including the relationship with neurofibromatosis type 1. Clinical presentation includes: Diabetes mellitus, cholelithiasis, steatorrhea, abdominal pain, and obstructive jaundice while papillary tumour may cause acute pancreatitis. The neoplasia may develop completely asymptomatic or it is detected as an incidental finding during an imaging or a surgical procedure. It may be sporadic or associated to genetic backgrounds especially for duodenal localisation as neurofibromatosis type 1 (NF1 gene with malfunction of RAS/MAPK pathway) or Pacak-Zhuang syndrome (EPAS1 gene encoding HIF). Surgery represents the central approach if feasible but the prognostic depends on location, and grading as indicated by WHO 2017 classification of neuroendocrine tumours. Previously known as Von Recklinghausen disease, neurofibromatosis type 1, the most frequent neurocutaneous syndrome, is an autosomal dominant disorder including: Café-au-lait spot, skin fold freckling on flexural zones, and neurofibromas as well as tumours such as gliomas of optic nerve, gastrointestinal stromal tumours (GISTs), iris hamartomas and brain tumours. Duodenal somatostatinoma is associated with the syndrome which actually involves more often a duodenal tumour of GIST type than a somatostatin secreting neoplasia. Other neuroendocrine tumours are reported: Gastrointestinal NENs at the level of rectum or jejunum and pheocromocytoma. Overall, one quarter of subjects have gastrointestinal tumours of different types. Somatostatinoma, when not located on pancreas but in duodenoum, may be registered in subjects with neurofibromatosis type 1 most probably in addition to other tumours. Overall, this type of neuroendocrine tumour with a challenging presentation has a poor prognosis unless adequate radical surgery is promptly offered to the patient.
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Affiliation(s)
- Florica Sandru
- Department of Dermatology, 'Elias' Emergency University Hospital, 125100 Bucharest, Romania.,Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mara Carsote
- Department of Endocrinology, 'C.I. Parhon' National Institute of Endocrinology, 011863 Bucharest, Romania.,Department of Endocrinology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ana Valea
- Department of Endocrinology, Clinical County Hospital, 400000 Cluj-Napoca, Romania.,Department of Endocrinology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Simona Elena Albu
- Department of Gynecology, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Răzvan-Cosmin Petca
- Deparment of Urology, 'Prof. Dr. Theodor Burghele' Clinical Hospital, 925200 Bucharest, Romania
| | - Mihai Cristian Dumitrascu
- Department of Gynecology, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Thavaraputta S, Graham S, Rivas Mejia AM, Lado-Abeal J. Duodenal somatostatinoma presenting as obstructive jaundice with the coexistence of a gastrointestinal stromal tumour in neurofibromatosis type 1: a case with review of the literature. BMJ Case Rep 2019; 12:12/1/bcr-2018-226702. [PMID: 30635305 DOI: 10.1136/bcr-2018-226702] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Somatostatinomas are rare neuroendocrine tumours, mostly located in the pancreas or duodenum, with an estimated incidence of 1 in 40 million. Duodenal somatostatinomas (DSs) are usually found in association with neurofibromatosis type 1 (NF1), tuberous sclerosis and Von Hippel-Lindau syndrome. Gastrointestinal stromal tumours (GIST) have also been described in NF1, but the association with somatostatinoma is very uncommon. We report the case of a patient with NF1 who presented with obstructive jaundice due to multiple firm nodules around the ampulla of Vater. A pancreaticoduodenectomy was performed and revealed a 1 cm duodenal/ampullary mass which stained positive for somatostatin, together with a GIST also found on the duodenal wall. Despite its rarity, ampullary somatostatinomas should be considered in the differential diagnosis of biliary tract dilation in patients with NF1.
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Affiliation(s)
- Subhanudh Thavaraputta
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Suzanne Graham
- Department of Pathology, Texas Tech Univeristy Health Sciences Center, Lubbock, Texas, USA
| | - Ana M Rivas Mejia
- Division of Endocrinology, Department of Internal Medicine, Texas Tech University Health Science Center School of Medicine, Lubbock, Texas, USA
| | - Joaquin Lado-Abeal
- Division of Endocrinology, Department of Internal Medicine, Texas Tech University Health Science Center School of Medicine, Lubbock, Texas, USA
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Mixed mucinous adenocarcinoma and somatostatinoma of the ampulla of Vater associated with neurofibromatosis type 1. Pathology 2017; 49:553-555. [PMID: 28693748 DOI: 10.1016/j.pathol.2017.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/18/2017] [Accepted: 03/29/2017] [Indexed: 12/31/2022]
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Somatostatinoma of the Ampulla: An Incidental Postoperative Finding Following Colorectal Cancer Resection. ACG Case Rep J 2016; 3:109-11. [PMID: 26958562 PMCID: PMC4748198 DOI: 10.14309/crj.2016.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 11/11/2015] [Indexed: 12/03/2022] Open
Abstract
Somatostatinoma of the gastrointestinal tract is a rare finding, especially arising from the ampulla of Vater. We present a man recently diagnosed with rectal adenocarcinoma who was found on imaging to have an ampullary mass. Histology and immunohistochemical staining of the biopsied tissue were consistent with a nonfunctioning somatostatinoma. The patient had neurofibromatosis, which have been reported in patients with ampullary somatostatinomas. Our case highlights the importance of gastrointestinal findings in those with underlying genetic conditions.
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Neophytou H, Mathieu A, Monseu M, Roblet D, Boissonot O, Andrieux V, Furudoï A, Donatini G. Upper gastrointestinal haemorrhage due to a small extra-papillary duodenal neuroendocrine tumour expressing somatostatin. ANNALES D'ENDOCRINOLOGIE 2015; 76:697-701. [PMID: 26593862 DOI: 10.1016/j.ando.2015.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 05/17/2015] [Accepted: 06/02/2015] [Indexed: 01/13/2023]
Affiliation(s)
- Helene Neophytou
- Service de chirurgie digestive, hôpital d'Angoulême, rond-point de Girac, 16959 Angoulême cedex, France.
| | - Anne Mathieu
- Service de chirurgie digestive, hôpital d'Angoulême, rond-point de Girac, 16959 Angoulême cedex, France
| | - Mathilde Monseu
- Service de médecine interne, hôpital Bretonneau, CHU de Tours, boulevard Tonnelé, Tours, France
| | - Denis Roblet
- Service d'anatomopathologie, hôpital d'Angoulême, rond-point de Girac, 16959 Angoulême cedex, France
| | - Olivier Boissonot
- Service de radiologie, hôpital d'Angoulême, rond-point de Girac, 16959 Angoulême cedex, France
| | - Vladimir Andrieux
- Service de gastrologie, hôpital d'Angoulême, rond-point de Girac, 16959 Angoulême cedex, France
| | - Adeline Furudoï
- Service d'anatomie pathologique, hôpital de Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France
| | - Gianluca Donatini
- Service de chirurgie endocrinienne, CHU de Poitiers, rue de la Milétrie, 86000 Poitiers, France
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