American Association of Endocrine SurgeonsUse of somatostatin receptor scintigraphy to image extrahepatic metastases of neuroendocrine tumors☆
Section snippets
Patients and methods
We prospectively studied 35 consecutive patients with confirmed histologic diagnosis of neuroendocrine tumors who were referred to the Department of Surgery, University Hamburg, between September 1992 and March 1998 for treatment of liver metastases diagnosed elsewhere (Table I).
Tumor histologic diagnosis No. Carcinoid 24 MTC 4 Insulinoma 2 Gastrinoma 1 MEN 1 gastrinoma 1 MEN 1 VIPoma 1 MEN 2
Results
The presence of liver metastases was confirmed in all 35 patients by CT, MRI, and ultrasonography. Additionally, in 4 patients (11%) CT and MRI disclosed extrahepatic tumor. Two patients, 1 with gastrinoma and 1 with carcinoid, had bone metastases and in 2 patients with bronchial carcinoids extensive intra-abdominal lymph node metastases were diagnosed.
Octreotide scintigraphy showed liver metastases in each patient (Fig 1).
Discussion
The presence of liver metastases is the single most important prognostic factor in patients with malignant neuroendocrine tumors. Liver resection is the only potentially curative therapy and offers the best chance of survival. However, curative resection can only be achieved when there are no extrahepatic metastases or local tumor recurrence. To select candidates that should undergo surgery, extensive preoperative diagnostic workup including imaging techniques such as CT, MRI, and conventional
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Reprint requests: Andrea Frilling, MD, Department of General Surgery, University Hospital Essen, Hufelandstr 55, 42155 Essen, Germany.