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A. Scott Paulson and Emily K. Bergsland

the foregut (lungs, thymus, stomach, duodenum), midgut (small bowel, cecum, appendix), or hindgut (descending colon, rectum). Carcinoid tumors are relatively indolent, but the treatment of advanced disease remains a serious challenge. 11 , 12

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David Bushnell

neuroendocrine tumours. An observational, cross-sectional study . Neuroendocrinology 2005 ; 82 : 215 – 220 . 23 Quigley AM Buscombo JR Gopinath G . In-vivo characterisation of the functional aspects of carcinoid tumors by imaging somatostatin

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Larry K. Kvols, Kiran K. Turaga, Jonathan Strosberg, and Junsung Choi

-catheter arterial chemoembolization as first-line treatment for hepatic metastases from endocrine tumors . Eur Radiol 2003 ; 13 : 136 – 140 . 19 Diaco DS Hajarizadeh H Mueller CR . Treatment of metastatic carcinoid tumors using multimodality therapy

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E. S. Delpassand, Rodolfo Nunez, D. Ranganathan, N. Wagh, A. Shafie, A. Gaber, I. Tworowska, and A. Abbasi

-DOTATATE PET/CT is a safe imaging technique that provides high quality images (figure) and excellent accuracy (98%) for detection of SST expressing NETs. Figure Maximum intensity projection image (A) of a patient with metastatic small bowel carcinoid tumor

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Diane L. Reidy-Lagunes

Well-differentiated neuroendocrine tumors (NETs) can be subdivided into carcinoid and pancreatic NETs (pancNETs). Although these tumors share many morphologic and clinical characteristics, carcinoid tumors seem to be far less sensitive to

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Ariel Polish, Maxwell T. Vergo, and Mark Agulnik

based on their ability to secrete hormones. Functionally active tumors are defined by the hormones they secrete and include insulinomas, gastrinomas, vasoactive intestinal polypeptidoma (VIPoma), glucagonomas, and carcinoid tumors. Regardless of the

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In the year 2005, an estimated 31,800 people will die of pancreatic cancer in the United States. This disease is the fourth most common cause of cancer-related death among men in the United States. Its peak incidence occurs in the seventh and eighth decades of life. Although incidence is roughly equal in the two sexes, African Americans appear to have a higher incidence of pancreatic cancer than white Americans. In these NCCN Pancreatic Adenocarcinoma guidelines, only tumors of the exocrine pancreas are discussed; endocrine tumors from the islets of Langerhans and carcinoid tumors are not included.

For the most recent version of the guidelines, please visit NCCN.org

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Neuroendocrine tumors affect cells throughout the nervous and endocrine systems that produce and secrete regulatory hormones. Common sites of origin include the endocrine pancreas; parathyroid, adrenal, and pituitary glands; calcitonin-producing cells of the thyroid (causing medullary thyroid carcinoma); and argentaffin cells of the gut (causing carcinoid tumors). Neuroendocrine tumors are rare and can be broadly subdivided into those with and those without a clinical syndrome. Most neuroendocrine tumors are malignant and metastasize commonly to lymph nodes and the liver or less commonly to bone, lung, brain, and other organs. Despite the widespread metastasis, these tumors are typically slow-growing and often have an insidious presentation. These guidelines discuss the diagnosis and management of neuroendocrine tumors and special considerations relating to these tumors; important updates include expanded information on octreotide use and a new algorithm on neuroendocrine tumors of unknown primary.

For the most recent version of the guidelines, please visit NCCN.org

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regimen. Contact: Steve K. West, BS, CCRP • 901-722-0581 • steve.west@bmhcc.org ClinicalTrials.gov Identifie r: NCT00777673 A Phase II Study of Axitinib in Advanced Carcinoid Tumors Principal Investigators: Jonathan Strosberg, MD, and

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Lin-Chi Chen, William D. Travis, and Lee M. Krug

Cancer J Clin 2006 ; 56 : 106 – 130 . 2. Modlin IM Lye KD Kidd M . A 5-decade analysis of 13,715 carcinoid tumors . Cancer 2003 ; 97 : 934 – 959 . 3. Travis WD Linnoila RI Tsokos MG . Neuroendocrine tumors of the lung with