Neuroendocrine Tumours Flashcards
Neuroendocrine tumours are always benign. T/F?
False - these tumours can be malignant or benign
What are neuroendocrine tumours?
Rare tumours which affect the neuroendocrine cells that release hormones into the bloodstream
What are the different types of neuroendocrine tumours
Carcinoid tumours - GI tract, lungs, thymus
Pancreatic neuroendocrine tumours
Phaechromocytomas / paragangliomas
Most neuroendocrine tumours are sporadic but some are associated with hereditary tumour syndromes such as…?
MEN type 1
VHL
Neurofibromatosis 1
What is MEN1?
Multiple endocrine neoplasia type 1 is an autosomal predisposition to tumours of the parathyroids, anterior pituitary and enteropancreatic endocrine cells
How is MEN1 defined clinically?
The occurrence of 2 or more primary MEN 1 tumour types
What are the symptoms of carcinoid syndrome?
Flushing
Diarrhoea
Asthma
Right heart valvular lesions
How is hypoglycaemia defined in patients with diabetes?
Plasma glucose of <4 mmol/l
How is hypoglycaemia defined in patients without documented diabetes?
Plasma glucose of <3 mmol/l
What are the autonomic symptoms of hypoglycaemia?
Sweating Palpitations Pallor Tremor Nausea Irritability Hunger
What are the neuroglycopenic symptoms of hypoglycaemia?
Inability to concentrate Confusion Drowsiness Personality change Slurred speech Incoordination Weakness Dizziness Vision impairment Headache Seizures Coma
What is Whipple’s triad?
Symptoms consistent with hypoglycaemia
Low plasma glucose concentration
Relief of symptoms after plasma glucose level is raised
How can a spontaneous hypoglycaemic episode be investigated>
Baseline U&Es, LFTs, TFTs and HbA1c Synacthen test 72 hour fast Radiology Arterial calcium stimulation
When can arterial calcium stimulation be used in the investigation of hypoglycaemia?
When endogenous hyperinsulinaemic hypoglycaemia is present and there is negative imaging
What is the purpose of arterial. calcium simulation in the investigation of hypoglycaemia?
To distinguish between focal. (insulinoma) from diffuse disease (functional islet cell disorders)
