Strategy for pancreatic endocrine tumors.
OBJECTIVE
The endocrine tumors of the pancreas are rare diseases and there is no established standard therapy for the liver metastasis of pancreatic endocrine tumors. In this study, the therapy for the pancreatic endocrine tumors was evaluated.


METHODS
The endocrine pancreas tumors of 13 patients had been surgically treated. All primary tumors were completely resected. The liver metastasis was recognized in 4 patients. Partial resection of the liver was performed in 2 patients. Lipiodol-transcatheter arterial embolization was performed for synchronous unresectable liver metastases in the other 2 patients.


RESULTS
The patients with no liver metastases survived without recurrence (max: 18.8 yr; mean follow-up: 9.2 yr). The patient with resected synchronous solitary liver metastasis died of recurrent multiple liver metastases 5 months after surgery. The other patient with the metachronous liver metastasis completely resected survived 13.9 years. In the 2 patients with unresectable numerous liver metastases, after lipiodol-transcatheter arterial embolization, tumor necrosis rate was more than 90% in both cases and serum gastrin level was normalized.


CONCLUSIONS
Complete resection of liver metastasis is favorable, whereas lipiodol-transcatheter arterial embolization is effective for unresectable liver metastases from pancreatic endocrine tumors as palliation. Complete resection of the primary site is recommended even in the cases with unresectable numerous liver metastases.
Sato
T
T
Department of Surgery, Toyama Prefectural Central Hospital, Japan. YIB03163@niftyserve.or.jp
Konishi
K
K
Kimura
H
H
Maeda
K
K
Yabushita
K
K
Tsuji
M
M
Demachi
H
H
Miwa
A
A
D000328:Adult; D000368:Aged; D000792:Angiography; D005260:Female; D005500:Follow-Up Studies; D015408:Gastrinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D013005:Somatostatinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D015996:Survival Rate; D014057:Tomography, X-Ray Computed