Neuro-endocrine tumours (gastrinoma amongst others)

These are uncommon tumours derived from neuro-endocrine cells. Neuro-endocrine cells are found in a wide variety of tissues including the lungs and the gut. These cells are best regarded as specially adapted nerve cells which instead of secreting neurotransmitters secrete hormones into the bloodstream, effectively giving them “endocrine” properties. These hormones then have effects on other organs. Whilst neuroendocrine tumours are often slow growing they are usually malignant. Tumours arising from neuro-endocrine cells may be functional, in other words hormone secreting, or non-functional, in other words non secreting.

Within the gut gastrinomas, and insulinomas represent two functional neuro-endocrine tumours. Both these tumours are seen most commonly in the context of a genetic condition known as multiple endocrine neoplasis (MEN). Gastrinomas secrete a hormone called gastrin, this controls gastric acid secretion. Consequently they may present with symptoms of duodenal, gastric and oesophageal ulceration which arise as a result of excess acid. Diarrhoea is also a common feature of gastrinomas. Insulinomas secrete insulin. Insulin drives sugar into cells consequently patients may present low blood sugar. Other neuro-endocrine tumours grow without which secreting ant hormones. Most neuro-endocrine tumours arise in the duodenum, stomach or tail of the pancreas. 

Treatment depends on the stage (the extent to which the tumour has invaded and spread to other structures and the grade (how aggressive or abnormal the cells appear) of the tumour. It is also dependant upon the physical state and co-morbidities of the individual patient.