Glucagonoma natural history, complications and prognosis: Difference between revisions
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== Complications == | == Complications == | ||
Complications of glucagonoma include: | |||
* Metastasis: | * Metastasis: | ||
**Glucagonomas are generally slow-growing but are usually advanced by the time of diagnosis. | **Glucagonomas are generally slow-growing but are usually advanced by the time of diagnosis. | ||
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==Prognosis== | ==Prognosis== | ||
Prognosis of glucagonoma depends on the following: | |||
*Whether or not the tumor can be removed by surgery. | |||
*The [[stage of the tumor]], the size of the tumor, whether cancer has [[spread]] outside [[the pancreas]]. | |||
*The patient’s general health. | |||
*Whether the tumor has just been diagnosed or has recurred. | |||
*The presence of [[metastasis]] is associated with a particularly poor prognosis among patients with glucagonoma. | |||
*The 10-year event free [[survival rate]] is less than 51.6% with [[metastasis]] and 64.3% without metastasis. | |||
Additionally: | |||
* [[Age]], [[grade]], and distant [[metastases]] are the most significant predictors of survival. | * [[Age]], [[grade]], and distant [[metastases]] are the most significant predictors of survival. | ||
* Five and 10-year survival rates for patients undergoing resection of gastroenteropancreatic [[neuroendocrine tumors]].<ref name="pmid8606627">{{cite journal| author=Wermers RA, Fatourechi V, Wynne AG, Kvols LK, Lloyd RV| title=The glucagonoma syndrome. Clinical and pathologic features in 21 patients. | journal=Medicine (Baltimore) | year= 1996 | volume= 75 | issue= 2 | pages= 53-63 | pmid=8606627 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8606627 }}</ref> | * Five and 10-year survival rates for patients undergoing resection of gastroenteropancreatic [[neuroendocrine tumors]].<ref name="pmid8606627">{{cite journal| author=Wermers RA, Fatourechi V, Wynne AG, Kvols LK, Lloyd RV| title=The glucagonoma syndrome. Clinical and pathologic features in 21 patients. | journal=Medicine (Baltimore) | year= 1996 | volume= 75 | issue= 2 | pages= 53-63 | pmid=8606627 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8606627 }}</ref> | ||
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| pmid = 11370794 | | pmid = 11370794 | ||
}}</ref> | }}</ref> | ||
==References== | ==References== | ||
Revision as of 14:41, 17 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2], Mohammed Abdelwahed M.D[3]
Overview
If left untreated, patients with glucagonoma may progress to develop necrolytic migratory erythema, cheilosis, stomatitis, diarrhea, polyuria, and polydipsia. The presence of metastasis is associated with a particularly poor prognosis among patients with glucagonoma. The 10-year event free survival rate is less than 51.6% with metastasis and 64.3% without metastasis. Glucagonomas are generally slow-growing but are usually advanced by the time of diagnosis. Age, grade, and distant metastases are the most significant predictors of survival.
Natural History
- If left untreated, patients with glucagonoma may progress to develop necrolytic migratory erythema, cheilosis, stomatitis, diarrhea, polyuria, and polydipsia.
- Glucagonoma has a very slow growth rate compared to most malignant tumors.
Complications
Complications of glucagonoma include:
- Metastasis:
- Glucagonomas are generally slow-growing but are usually advanced by the time of diagnosis.
- Metastasis occurs mainly in the liver but in few cases, it can occur in lymph nodes, peritoneum, lung, and adrenals.
- Weight loss: due to the catabolic effect of glucagon, most patients lose weight.
- Anemia
- Neuropsychiatric manifestations include depression, dementia, psychosis, and agitation
- Reversible dilated cardiomyopathy[1]
Prognosis
Prognosis of glucagonoma depends on the following:
- Whether or not the tumor can be removed by surgery.
- The stage of the tumor, the size of the tumor, whether cancer has spread outside the pancreas.
- The patient’s general health.
- Whether the tumor has just been diagnosed or has recurred.
- The presence of metastasis is associated with a particularly poor prognosis among patients with glucagonoma.
- The 10-year event free survival rate is less than 51.6% with metastasis and 64.3% without metastasis.
Additionally:
- Age, grade, and distant metastases are the most significant predictors of survival.
- Five and 10-year survival rates for patients undergoing resection of gastroenteropancreatic neuroendocrine tumors.[2]
- Sixty percent of glucagonomas are malignant. Once the tumor is metastatic, the cure is rare.[3]
References
- ↑ K. Chang-Chretien, J. T. Chew & D. P. Judge. "Reversible dilated cardiomyopathy associated with glucagonoma". Heart (British Cardiac Society). 90 (7): e44. doi:10.1136/hrt.2004.036905. PMID 15201270.
- ↑ Wermers RA, Fatourechi V, Wynne AG, Kvols LK, Lloyd RV (1996). "The glucagonoma syndrome. Clinical and pathologic features in 21 patients". Medicine (Baltimore). 75 (2): 53–63. PMID 8606627.
- ↑ M. A. Chastain (2001). "The glucagonoma syndrome: a review of its features and discussion of new perspectives". The American journal of the medical sciences. 321 (5): 306–320. PMID 11370794. Unknown parameter
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