[Diagnosis and therapy of active endocrine pancreatic tumors]

Diagnosis of endocrine pancreatic tumor syndromes is based on the characteristic spectrum of symptoms and the demonstration of inappropriately high serum levels of the tumor's secretory products. Available imaging methods cannot visualize pancreatic tumors with a diameter of less than 1 cm and are diagnostic in 50 to 60% only. With the introduction of endoscopic sonography and somatostatin receptor scintigraphy, detection of tumors has been improved. Therapeutic principles include surgical extirpation, primarily in the absence of metastases, and medical control of symptoms. In the case of metastatic disease, tumor growth and symptoms can be controlled by a variety of procedures including somatostatin analogs with and without additional alpha-interferon, polychemotherapy, embolization, surgical tumor debulking and liver transplantation.