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Somatostatinomas Medication

  • Author: Praveen K Roy, MD, AGAF; Chief Editor: Julian Katz, MD  more...
 
Updated: Jun 29, 2015
 

Medication Summary

Streptozocin, 5-FU, and doxorubicin are the agents most commonly used in the treatment of somatostatin-secreting pancreatic neoplasms. Although 50% of patients may sustain a partial humoral and tumor response, the reported numbers are too small to reliably judge efficacy.

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Antineoplastic agents

Class Summary

Inhibit cell growth and proliferation.

Streptozocin (Zanosar)

 

Antineoplastic agent used in other gastrointestinal neuroendocrine tumors (including pancreatic islet cell and carcinoid tumors).

Fluorouracil (Adrucil)

 

Fluorinated pyrimidine antimetabolite that inhibits thymidylate synthase and also interferes with RNA synthesis and function. Has some effect on DNA. Useful in symptom palliation for patients with progressive disease.

Doxorubicin (Adriamycin, Rubex)

 

Inhibits topoisomerase II and produces free radicals, which may cause the destruction of DNA. The combination of these two events can inhibit the growth of neoplastic cells.

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Contributor Information and Disclosures
Author

Praveen K Roy, MD, AGAF Chief of Gastroenterology, Presbyterian Hospital; Medical Director of Endoscopy, Presbyterian Medical Group; Adjunct Associate Research Scientist, Lovelace Respiratory Research Institute

Praveen K Roy, MD, AGAF is a member of the following medical societies: American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Coauthor(s)

Rajan Kanth, MD Hospitalist, Ministry Saint Joseph’s Hospital

Rajan Kanth, MD is a member of the following medical societies: American College of Physicians, Society of Hospital Medicine, Nepal Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Acknowledgements

Mounzer Al Samman, MD Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, Texas Tech University School of Medicine

Mounzer Al Al Samman, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, and American Gastroenterological Association

Disclosure: Nothing to disclose.

Michael Cooperman, MD Clinical Associate Professor of Endocrinology, Temple University; Chair, Department of Internal Medicine, Division of Endocrinology, Jeanes Hospital

Michael Cooperman, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Clinical Endocrinologists, and Endocrine Society

Disclosure: Nothing to disclose.

Eric J Hanly, MD Resident, Department of Surgery, The Johns Hopkins University School of Medicine; Fellow, Department of Surgery, The Johns Hopkins University School of Medicine

Eric J Hanly, MD is a member of the following medical societies: American Medical Association, Association of Military Surgeons of the US, MedChi, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Michael G House, MD Fellow, Department of Oncology, Johns Hopkins University

Disclosure: Nothing to disclose.

Leon W Kundrotas, MD, Col, USAF, MC Chief, Medical Staff 48th Medical Group, Malcolm Grow Medical Center; Assistant Professor, Department of Medicine, USAF Hospital

Leon W Kundrotas, MD, Col, USAF, MC is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Michael R Marohn, DO Associate Professor, Department of Surgery and Surgical Sciences, John Hopkins University School of Medicine

Disclosure: Nothing to disclose.

Noel Williams, MD Professor Emeritus, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Professor, Department of Internal Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada

Noel Williams, MD is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Charles J Yeo, MD Samuel D Gross Professor and Chair of Surgery at Jefferson Medical College of Thomas Jefferson University and at Thomas Jefferson University Hospital

Charles J Yeo, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Endocrine Surgeons, American College of Surgeons, American Gastroenterological Association, American Hepato-Pancreato-Biliary Association, American Surgical Association, Association for Academic Surgery, Johns Hopkins Medical and Surgical Association, Pancreas Club, Phi Beta Kappa, Sigma Xi, Society for Surgery of the Alimentary Tract, and Society of University Surgeons

Disclosure: Nothing to disclose.

References
  1. Williamson JM, Thorn CC, Spalding D, Williamson RC. Pancreatic and peripancreatic somatostatinomas. Ann R Coll Surg Engl. 2011 Jul. 93(5):356-60. [Medline]. [Full Text].

  2. Ellison TA, Edil BH. The current management of pancreatic neuroendocrine tumors. Adv Surg. 2012. 46:283-96. [Medline].

  3. Boden G, Shimoyama R. Somatostatinoma. Cohen S, Soloway RD, eds. Hormone-Producing Tumors of the Gastrointestinal Tract. New York, NY: Churchill Livingstone; 1985. 85.

  4. Norton JA, Levin B, Jensen RT. Cancer of the endocrine system. DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 4th ed. Philadelphia, Pa: Lippincott-Raven; 1993. 1333-435.

  5. Yeo CJ. Neoplasms of the endocrine pancreas. Greenfield LJ, Mulholland MW, Oldham KT, eds. Surgery: Scientific Principles and Practice. 3rd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2001. 899-913.

  6. Williamson JM, Thorn CC, Spalding D, Williamson RC. Pancreatic and peripancreatic somatostatinomas. Ann R Coll Surg Engl. 2011 Jul. 93(5):356-60. [Medline]. [Full Text].

  7. Larsson LI, Hirsch MA, Holst JJ, et al. Pancreatic somatostatinoma. Clinical features and physiological implications. Lancet. 1977 Mar 26. 1(8013):666-8. [Medline].

  8. Ganda OP, Weir GC, Soeldner JS. "Somatostatinoma": a somatostatin-containing tumor of the endocrine pancreas. N Engl J Med. 1977 Apr 28. 296(17):963-7. [Medline].

  9. Krejs GJ, Orci L, Conlon JM, et al. Somatostatinoma syndrome. Biochemical, morphologic and clinical features. N Engl J Med. 1979 Aug 9. 301(6):285-92. [Medline].

  10. Colovic RB, Matic SV, Micev MT, et al. Two synchronous somatostatinomas of the duodenum and pancreatic head in one patient. World J Gastroenterol. 2009 Dec 14. 15(46):5859-63. [Medline]. [Full Text].

  11. Bhandari R, Riddiough G, Lokan J, Weinberg L, Efthymiou M, Nikfarjam M. Somatostatinoma of the minor papilla treated by local excision in a patient with neurofibromatosis type 1. JOP. 2015 Jan 31. 16(1):81-4. [Medline].

  12. Tanaka S, Yamasaki S, Matsushita H, et al. Duodenal somatostatinoma: a case report and review of 31 cases with special reference to the relationship between tumor size and metastasis. Pathol Int. 2000 Feb. 50(2):146-52. [Medline].

  13. Stelow EB, Woon C, Pambuccian SE, et al. Fine-needle aspiration cytology of pancreatic somatostatinoma: the importance of immunohistochemistry for the cytologic diagnosis of pancreatic endocrine neoplasms. Diagn Cytopathol. 2005 Aug. 33(2):100-5. [Medline].

  14. Mori Y, Sato N, Taniguchi R, et al. Pancreatic somatostatinoma diagnosed preoperatively: report of a case. JOP. 2014 Jan 10. 15(1):66-71. [Medline].

  15. Barresi L, Tarantino I, Ligresti D, et al. Endoscopic ultrasound-guided fine-needle aspiration diagnosis of mixed endocrine somatostatinoma of the minor papilla in von Recklinghausen disease. Endoscopy. 2014. 46 suppl 1 UCTN:E664-5. [Medline].

  16. Ellison TA, Edil BH. The current management of pancreatic neuroendocrine tumors. Adv Surg. 2012. 46:283-96. [Medline].

  17. Machado MC. Surgical treatment of pancreatic endocrine tumors in multiple endocrine neoplasia type 1. Clinics (Sao Paulo). 2012. 67 Suppl 1:145-8. [Medline]. [Full Text].

  18. Anene C, Thompson JS, Saigh J, et al. Somatostatinoma: atypical presentation of a rare pancreatic tumor. Am J Gastroenterol. 1995 May. 90(5):819-21. [Medline].

  19. Angeletti S, Corleto VD, Schillaci O, et al. Use of the somatostatin analogue octreotide to localise and manage somatostatin-producing tumours. Gut. 1998 Jun. 42(6):792-4. [Medline].

  20. Berger JF, Laissy JP, Limot O, et al. Differentiation between multiple liver hemangiomas and liver metastases of gastrinomas: value of enhanced MRI. J Comput Assist Tomogr. 1996 May-Jun. 20(3):349-55. [Medline].

  21. Bieligk S, Jaffe BM. Islet cell tumors of the pancreas. Surg Clin North Am. 1995 Oct. 75(5):1025-40. [Medline].

  22. Caiazzo R, Mariette C, Piessen G, et al. [Type I neurofibromatosis, pheochromocytoma and somatostatinoma of the ampulla. Literature review] [French]. Ann Chir. 2006 Jul-Aug. 131(6-7):393-7. [Medline].

  23. Chetty R, Vajpeyi R. Vasculopathic changes, a somatostatin-producing neuroendocrine carcinoma and a jejunal gastrointestinal stromal tumor in a patient with type 1 neurofibromatosis. Endocr Pathol. 2009 Fall. 20(3):177-81. [Medline].

  24. Dayal Y, Tallberg KA, Nunnemacher G, et al. Duodenal carcinoids in patients with and without neurofibromatosis. A comparative study. Am J Surg Pathol. 1986 May. 10(5):348-57. [Medline].

  25. Debas HT, Mulvihill SJ. Neuroendocrine gut neoplasms. Important lessons from uncommon tumors. Arch Surg. 1994 Sep. 129(9):965-71; discussion 971-2. [Medline].

  26. Fendrich V, Ramaswamy A, Slater EP, Bartsch DK. Duodenal somatostatinoma associated with Von Recklinghausen's disease. J Hepatobiliary Pancreat Surg. 2004. 11(6):417-21. [Medline].

  27. Fraker DL, Alexander HR. The surgical approach to endocrine tumors of the pancreas. Semin Gastrointest Dis. 1995 Apr. 6(2):102-13. [Medline].

  28. Friesen SR. Update on the diagnosis and treatment of rare neuroendocrine tumors. Surg Clin North Am. 1987 Apr. 67(2):379-93. [Medline].

  29. Frilling A, Malago M, Martin H, Broelsch CE. Use of somatostatin receptor scintigraphy to image extrahepatic metastases of neuroendocrine tumors. Surgery. 1998 Dec. 124(6):1000-4. [Medline].

  30. Gibril F, Doppman JL, Jensen RT. Recent advances in the treatment of metastatic pancreatic endocrine tumors. Semin Gastrointest Dis. 1995 Apr. 6(2):114-21. [Medline].

  31. Gibril F, Reynolds JC, Doppman JL, et al. Somatostatin receptor scintigraphy: its sensitivity compared with that of other imaging methods in detecting primary and metastatic gastrinomas. A prospective study. Ann Intern Med. 1996 Jul 1. 125(1):26-34. [Medline].

  32. Glover JR, Shorvon PJ, Lees WR. Endoscopic ultrasound for localisation of islet cell tumours. Gut. 1992 Jan. 33(1):108-10. [Medline].

  33. Goudet P, Murat A, Binquet C, et al. Risk factors and causes of death in MEN1 disease. A GTE (Groupe d'Etude des Tumeurs Endocrines) cohort study among 758 patients. World J Surg. 2009 Dec 1. epub ahead of print. [Medline].

  34. Grant CS, van Heerden J, Charboneau JW, et al. Insulinoma. The value of intraoperative ultrasonography. Arch Surg. 1988 Jul. 123(7):843-8. [Medline].

  35. Gunther RW, Klose KJ, Ruckert K, et al. Localization of small islet-cell tumors. Preoperative and intraoperative ultrasound, computed tomography, arteriography, digital subtraction angiography, and pancreatic venous sampling. Gastrointest Radiol. 1985. 10(2):145-52. [Medline].

  36. Hammond PJ, Jackson JA, Bloom SR. Localization of pancreatic endocrine tumours. Clin Endocrinol (Oxf). 1994 Jan. 40(1):3-14. [Medline].

  37. He X, Wang J, Wu X, Kang L, Lan P. Pancreatic somatostatinoma manifested as severe hypoglycemia. J Gastrointestin Liver Dis. 2009 Jun. 18(2):221-4. [Medline].

  38. Heitz PU, Kasper M, Polak JM, Kloppel G. Pancreatic endocrine tumors. Hum Pathol. 1982 Mar. 13(3):263-71. [Medline].

  39. Hendi JM, Horton KM, Fishman EK. Somatostatinoma of the ampulla and appendical carcinoid in a patient with von Recklinghausen disease. J Comput Assist Tomogr. 2005 May-Jun. 29(3):418-9.

  40. House MG, Yeo CJ, Schulick RD. Periampullary pancreatic somatostatinoma. Ann Surg Oncol. 2002 Nov. 9(9):869-74. [Medline].

  41. Kimura R, Hayashi Y, Takeuchi T. Large duodenal somatostatinoma in the third portion associated with severe glucose intolerance. Intern Med. 2004 Aug. 43(8):704-7. [Medline].

  42. Kirkwood KS, Debas HT. Neuroendocrine tumors: common presentations of uncommon diseases. Compr Ther. 1995 Dec. 21(12):719-25. [Medline].

  43. Kloppel G, Anlauf M. Epidemiology, tumour biology and histopathological classification of neuroendocrine tumours of the gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2005 Aug. 19(4):507-17.

  44. Konomi K, Chijiiwa K, Katsuta T, Yamaguchi K. Pancreatic somatostatinoma: a case report and review of the literature. J Surg Oncol. 1990 Apr. 43(4):259-65. [Medline].

  45. Krausz Y, Bar-Ziv J, de Jong RB, et al. Somatostatin-receptor scintigraphy in the management of gastroenteropancreatic tumors. Am J Gastroenterol. 1998 Jan. 93(1):66-70. [Medline].

  46. Lamberts SW, Bakker WH, Reubi JC, Krenning EP. Somatostatin-receptor imaging in the localization of endocrine tumors. N Engl J Med. 1990 Nov 1. 323(18):1246-9. [Medline].

  47. Levy-Bohbot N, Merle C, Goudet P. Prevalence, characteristics and prognosis of MEN 1-associated glucagonomas, VIPomas, and somatostatinomas: study from the GTE (Groupe des Tumeurs Endocrines) registry. Gastroenterol Clin Biol. 2004 Nov. 28(11):1075-81. [Medline].

  48. Lillemoe KD, Kaushal S, Cameron JL, et al. Distal pancreatectomy: indications and outcomes in 235 patients. Ann Surg. 1999 May. 229(5):693-8; discussion 698-700. [Medline].

  49. Madeira I, Terris B, Voss M, et al. Prognostic factors in patients with endocrine tumours of the duodenopancreatic area. Gut. 1998 Sep. 43(3):422-7. [Medline].

  50. Mansour JC, Chen H. Pancreatic endocrine tumors. J Surg Res. 2004 Jul. 120(1):139-61. [Medline].

  51. Marcial MA, Pinkus GS, Skarin A, et al. Ampullary somatostatinoma: psammomatous variant of gastrointestinal carcinoid tumor--an immunohistochemical and ultrastructural study. Report of a case and review of the literature. Am J Clin Pathol. 1983 Nov. 80(5):755-61. [Medline].

  52. Maton PN. The use of the long-acting somatostatin analogue, octreotide acetate, in patients with islet cell tumors. Gastroenterol Clin North Am. 1989 Dec. 18(4):897-922. [Medline].

  53. Menegaux F, Schmitt G, Mercadier M, Chigot JP. Pancreatic insulinomas. Am J Surg. 1993 Feb. 165(2):243-8. [Medline].

  54. Metz DC. Diagnosis and treatment of pancreatic neuroendocrine tumors. Semin Gastrointest Dis. 1995 Apr. 6(2):67-78. [Medline].

  55. Moore NR, Rogers CE, Britton BJ. Magnetic resonance imaging of endocrine tumours of the pancreas. Br J Radiol. 1995 Apr. 68(808):341-7. [Medline].

  56. Mozell E, Stenzel P, Woltering EA, et al. Functional endocrine tumors of the pancreas: clinical presentation, diagnosis, and treatment. Curr Probl Surg. 1990 Jun. 27(6):301-86. [Medline].

  57. Norton JA, Sigel B, Baker AR, et al. Localization of an occult insulinoma by intraoperative ultrasonography. Surgery. 1985 Mar. 97(3):381-4. [Medline].

  58. Pelley RJ, Bukowski RM. Recent advances in diagnosis and therapy of neuroendocrine tumors of the gastrointestinal tract. Curr Opin Oncol. 1997 Jan. 9(1):68-74. [Medline].

  59. Phan GQ, Yeo CJ, Cameron JL, et al. Pancreaticoduodenectomy for selected periampullary neuroendocrine tumors: fifty patients. Surgery. 1997 Dec. 122(6):989-96; discussion, 996-7. [Medline].

  60. Rosch T, Lightdale CJ, Botet JF, et al. Localization of pancreatic endocrine tumors by endoscopic ultrasonography. N Engl J Med. 1992 Jun 25. 326(26):1721-6. [Medline].

  61. Saifuddin T, Linder C, Banerjee B. Duodenal somatostatinoma presenting as upper gastrointestinal bleeding. Am J Gastroenterol. 1999 May. 94(5):1405-8. [Medline].

  62. Sawady J, Katzin WE, Mendelsohn G, Aron DC. Somatostatin-producing neuroendocrine tumor of the ampulla (ampullary somatostatinoma). Evidence of prosomatostatin production. Am J Clin Pathol. 1992 Mar. 97(3):411-5. [Medline].

  63. Schillaci O, Annibale B, Scopinaro F, et al. Somatostatin receptor scintigraphy of malignant somatostatinoma with indium-111-pentetreotide. J Nucl Med. 1997 Jun. 38(6):886-7. [Medline].

  64. Suzuki H, Kuwano H, Masuda N, et al. Diagnostic usefulness of FDG-PET for malignant somatostatinoma of the pancreas. Hepatogastroenterology. 2008 Jul-Aug. 55(85):1242-5. [Medline].

  65. Swinburn BA, Yeong ML, Lane MR, et al. Neurofibromatosis associated with somatostatinoma: a report of two patients. Clin Endocrinol (Oxf). 1988 Apr. 28(4):353-9. [Medline].

  66. Takizawa H, Kaneko H, Koike M, et al. Small duodenal somatostatinoma with high plasma somatostatin level. Am J Gastroenterol. 1997 Jun. 92(6):1063-4. [Medline].

  67. Tjon A Tham RT, Jansen JB, Falke TH, Lamers CB. Imaging features of somatostatinoma: MR, CT, US, and angiography. J Comput Assist Tomogr. 1994 May-Jun. 18(3):427-31. [Medline].

  68. Townsend CM Jr, Thompson JC. The clinical use of gastrointestinal hormones for alimentary tract disease. Adv Surg. 1996. 29:79-92. [Medline].

  69. Udelsman R, Yeo CJ, Hruban RH, et al. Pancreaticoduodenectomy for selected pancreatic endocrine tumors. Surg Gynecol Obstet. 1993 Sep. 177(3):269-78. [Medline].

  70. Vinik AI, Delbridge L, Moattari R, et al. Transhepatic portal vein catheterization for localization of insulinomas: a ten-year experience. Surgery. 1991 Jan. 109(1):1-11; discussion 111. [Medline].

  71. Vinik AI, Strodel WE, Eckhauser FE, et al. Somatostatinomas, PPomas, neurotensinomas. Semin Oncol. 1987 Sep. 14(3):263-81. [Medline].

  72. Zhang B, Xie QP, Gao SL, Fu YB, Wu YL. Pancreatic somatostatinoma with obscure inhibitory syndrome and mixed pathological pattern. J Zhejiang Univ Sci B. 2010 Jan. 11(1):22-6. [Medline]. [Full Text].

 
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