Neuroendokrine Tumoren des Gastrointestinaltraktes

Kernaussagen

Klassifikation

Gastrointestinale neuroendokrine Tumoren werden als funktionelle bzw. nichtfunktionelle Tumoren sowie nach Lokalisation und Proliferationsverhalten klassifiziert.

Die korrekte Klassifikation entscheidet über den zu wählenden Therapieansatz.

Diagnostik

Die Diagnose funktioneller neuroendokriner Tumor erfordert den Nachweis der autonomen Hormonsekretion.

Zur Lokalisationsdiagnostik werden Ultraschall, CT, MRT und Somatostatin-Rezeptor-Szintigraphie eingesetzt. Die Lokalisation kleiner Primärtumoren erfordert invasive Verfahren wie endoskopischen oder intraoperativen Ultraschall.

Therapie

Bei lokalisierter Erkrankung ist die Operation die Therapie der Wahl.

Ist die Erkrankung ausgedehnt, kommen neben symptomatischen Therapien die Biotherapie und/oder eine Chemotherapie in Betracht.

Zytoreduktive Verfahren (Chemoembolisation, Thermo- oder Kryoablation, palliative operative Therapie von Lebermetastasen) und die Radiorezeptortherapie gewinnen an Bedeutung, auch wenn die Datenlage noch keine abschließende Beurteilung der Effektivität dieser Therapien erlaubt.

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