Multimodal treatment of neuroendocrine tumors of the pancreas and the ampulla of Vater

Neuroendocrine tumors are not seen frequently. They are most commonly locat ed in the small bowel including the vermiform appendix. Neuroendocrine tumo rs of pancreatic origin are extremely rare. Symptoms caused by excessive ho rmone production by large liver metastases often lead to their diagnosis. P reoperative diagnostics include analysis of specific hormones in serum and urine, ultrasound, CT and somatostatin receptor scintigraphy. Liver metasta ses of neuroendocrine tumors of the pancreas are common at the time of diag nosis. Curative resection should be performed whenever possible, although p atients often benefit from debulking procedures, too. Liver metastases can be subjected to surgical resection, embolization, regional chemotherapy or local procedures such as alcohol injection or cryoablation. As an exception , liver transplantation can be considered in selected cases where radical s urgery for the primary tumor could be performed and extrahepatic metastases are not present. Supplementary or alternative options include octreotide a nd/or interferon-a administration. In this article, we report on 6 patients suffering from primary neuroendocrine tumors of the pancreas or the ampull a of Vater who were treated at our department over the past 5 years. In add ition, we discuss our own experience with this rare condition in the light of the recent literature.