[Clinical spectrum of digestive neuroendocrine tumors].
Digestive neuro-endocrine tumours have a broad and initially misleading clinical spectrum. Tumours from the duodenopancreatic area should be distinguished from digestive carcinoid tumours. In the first group, insulinomas, gastrinomas, and non-functioning tumours are the most frequent. Insulinoma is responsible for hypoglycaemic symptoms (coma, confusion, seizure, psychiatric disorders) associated with adrenergic response (sweat, tachycardia, palpitations). Gastrinoma is responsible for the Zollinger-Ellison syndrome, which associates peptic ulcers in the oesophagus, stomach, and duodenum without Helicobacter pylori infection, and chronic volumogenic diarrhoea. Non-functioning tumours are recognised fortuitously or at a late stage, when large tumour mass contrasts with often unaltered general condition. Carcinoid tumours are mainly located in the appendix, the rectum, and the small bowel. In the 2 first conditions, the diagnosis is most often made on a resection specimen after uneventful appendectomy or polypectomy; in the latter, the carcinoid syndrome is frequent, combining cutaneous flushing, motor diarrhoea, tricuspid valve insufficiency and bronchospasm.
Ruszniewski
Philippe
P
Service de gastroentérologie Fédération médico-chirurgicale d'hépatogastro-entérologie Hôpital Beaujon 92118 Clichy. philippe.ruszniewski@bjn.ap-hop-paris.fr
O'Toole
Dermot
D
D003937:Diagnosis, Differential; D015408:Gastrinoma / Q000150:complications / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications; D006801:Humans; D007340:Insulinoma / Q000150:complications / Q000473:pathology*; D008303:Malignant Carcinoid Syndrome / Q000473:pathology; D018358:Neuroendocrine Tumors / Q000150:complications / Q000473:pathology*; D015043:Zollinger-Ellison Syndrome / Q000209:etiology / Q000473:pathology
Spectre clinique des tumeurs neuro-endocrines digestives.