The diagnosis of neuroendocrine neoplasms

Abstract

The diagnosis of neuroendocrine tumors is based on the recognition of signs and symptoms of the structural and functional effects of these tumors. The structural impact depends on the location of the tumor; in some, such as the pituitary, the structural impact can be significant because of mass effects in a small enclosed and critical area, whereas in others, such as distal pancreas or retroperitoneal sites like adrenal, tumors can grow to be very large without major mass effects. The functional aspects of these tumors involve biochemical confirmation that can be very complex. In this chapter, the various hormone excess syndromes are discussed, along with the specific structural considerations at the common sites of neuroendocrine tumors. The wide array of clinical manifestations of neuroendocrine tumors emphasizes the importance of careful clinical history, sophisticated biochemical investigations, and thoughtful consideration of the potential for germline predisposition syndromes that are common in these disorders.