Gastro-entero-pancreatic tumors – Analysis of our 12 cases

The gastro-entero-pancreatic (GEP) tumor is a rare disease We have analyzed the features of our 12 pts with GEP tumors. During the last 5 years we had 12 pts with carcinoid tumor, one of them showed clinical and laboratory characteristics of gastrinoma later in the course of the disease. The mean age was 59 (36–73) years. The primary locations of the tumors were in stomach (3 cases), duodenum (2), pancreas (2), Vater papilla (2), jejunum (1), brochus (1), while in 1 pt it remained undetectable. Metastasis of the liver has revealed in a pt with unknown primary tumor, in another pt with brochial carcinoid and in 1 pt with pancreatic carcinoid. At first the result of the histology of percutaneous liver biopsy was misleading in 2 cases. Lymphatic metastasis was detected in a case of jejunal carcinoid, and local recurrence was revealed after 2yrs in a pt with pancreatic carcinoid and partial pancreatectomy. In cases of ventricular carcinoids we have performed endoscopic mucosectomy in 1 and partial gastrectomy in 2 pts. Even after a long follow up recurrence or metastasis were not disclosed. One of the duodenal carcinoids was polypoid type and was removed by polypectomy snare, the other needed duodenotomy. The jejunal carcinoid was resected, as well as the two others with papillary location. In pts with proven metastases we are applying long acting octreotid (Sandostatin LAR) treatment to control symptoms and decrease the growth of the tumor. The localization of GEP tumors significantly modify the therapeutic approach of these pts. Regular follow-up and care of them is essential to find the best solution (operation, interferon, Sandostatin treatment) for each patient.