ABSTRACT
This chapter reviews the management of Gastroenteropancreatic neuroendocrine tumors (GEP-NET), examines the potential for complications during the phases of diagnosis and preoperative management, operative management, and postoperative management, including the treatment of recurrent disease. GEP-NETs are a group of biologically complex, heterogenous lesions originating from the diffuse neuroendocrine cells of the embryologic gastrointestinal (GI) tract. The spectrum of presentation varies by tumor location within the GI tract and any associated biochemical activity. Gastrointestinal neuroendocrine tumors (G-NET) are primarily associated with a constellation of cutaneous and systematic symptoms, the “carcinoid syndrome.” Tumors of the midgut, arising from the enterochromaffin cells of the GI tract, secrete a variety of biologic amines including seratonin. G-NETs can consume large amounts of body niacin in the production of serotonin. Clinical presentation of large bowel G-NETs may not occur until a late stage due to the large colonic diameter and relative immunity to local mass effect.
