Our approach
Treating neuroendocrine tumors requires an individual approach.
We determine the location of the tumor, its functional activity, its grade of differentiation, the extent of the disease, and the presence of metastases. The treatment plan is developed by a multidisciplinary team of surgeons, oncologists, endocrinologists, and radiologists.
What are small bowel neuroendocrine tumors?
NETs are tumors that arise from cells capable of producing biologically active hormones.
They may be:
- non-functioning (do not produce hormones)
- functioning (cause hormonal syndromes)
The tumors are most often located in the ileum and may be multiple.
Why do NETs develop?
The exact cause of most tumors is unknown.
The risk is increased by:
- hereditary syndromes (MEN1)
- family predisposition
- certain genetic diseases
In most patients, the disease occurs sporadically.
Symptoms
In the early stages there may be no symptoms.
Possible manifestations:
- recurrent abdominal pain
- bowel obstruction
- intestinal bleeding
- weight loss
- diarrhea
- hot flushes
- skin flushing
- carcinoid syndrome (with hormone-producing tumors)
- metastatic liver disease
When to see a doctor
A consultation is recommended if:
- a small bowel tumor has been found
- a neuroendocrine tumor has been diagnosed by biopsy
- NET metastases have been found
- there are symptoms of carcinoid syndrome
- the surgical treatment strategy needs to be determined
How is the diagnosis made?
The following are used to establish the diagnosis:
- consultation with a surgical oncologist
- laboratory tests
- chromogranin A and other markers (when indicated)
- computed tomography
- magnetic resonance imaging
- endoscopic methods
- histological and immunohistochemical examination
- somatostatin receptor PET/CT (Gallium-68 DOTATATE PET/CT) when indicated
How is it treated?
The main treatment for localized NETs is radical surgery.
Depending on the clinical situation, the following are used:
- segmental resection of the small bowel
- removal of regional lymph nodes
- resection of multiple tumors
- surgery for liver metastases
- somatostatin analog therapy
- targeted therapy
- peptide receptor radionuclide therapy (PRRT) when indicated
- systemic drug treatment
Surgical treatment
At MSI we perform:
- radical small bowel resection
- oncological lymph node dissection
- laparoscopic operations in selected patients
- combined operations for locally advanced forms
- cytoreductive procedures for certain forms of metastatic disease
The goal of surgery is the most complete removal of the tumor possible and the best oncological outcome.
Recovery after treatment
At MSI, modern ERAS protocols are used to ensure fast postoperative recovery.
After surgery, patients remain under regular follow-up using modern laboratory and imaging methods.
Why choose MSI
- Specialization in oncological surgery of the digestive system
- A multidisciplinary approach
- Adherence to ENETS, NCCN, and ESMO guidelines
- Modern laparoscopic technology
- Comprehensive treatment of localized and metastatic NETs
- Enhanced recovery protocols (ERAS)
Frequently Asked Questions
Most NETs have malignant potential, although they often grow more slowly than adenocarcinomas. That is why they require specialized treatment and long-term follow-up.
In most cases, yes. Even small small-bowel NETs can spread to the regional lymph nodes, so surgical treatment is the method of choice.
Even when metastases are present, modern combined treatment often makes it possible to control the disease for a long time, improve quality of life, and extend the patient's life.
In many cases, yes. The final choice of approach depends on the location and extent of the tumor and the extent of resection required.
The outlook depends on the grade of the tumor, its stage, and the presence of metastases. With timely radical treatment of well-differentiated NETs, many patients live for decades with good disease control.