Benign and malignant tumors of endocrine glands
Endocrine and neuroendocrine tumors represent a large group of benign but also malignant tumors (neuro (endocrine) cancers). These are growths that can appear individually (where only one endocrine gland is affected) or in groups when two or more endocrine glands are affected. They can also occur in other organs outside the endocrine system. Depending on their secretory capacity, we distinguish between endocrine tumors that are hormonally active, i.e. they create and secrete a certain type of hormone and endocrine tumors that are hormonally inactive. Endocrine cancers are much more important in clinical practice, since they are malignant formations that have the potential for local and distant spread (metastases) and if timely diagnosis and treatment approaches are not made, they lead to death. When we talk about malignant endocrine cancers, we find thyroid cancer in the first place in terms of frequency, followed by other, fortunately less common tumors, such as pheochromocytoma, cancer of the cortex of the adrenal glands and parathyroid glands. Some organs contain a special types of cells (so-called APUD cells), from which neuroendocrine tumors can develop. They have a benign character, but sometimes show malignant characteristics. In clinical practice, we most often diagnose tumors of the pituitary gland, pancreas, adrenal medulla, but also neuroendocrine cancers that grow in the stomach, intestines, lungs, nervous system, esophagus and intestines. Patients present with extremely different symptoms, which are usually caused by excessive secretion of hormones from the tumor tissue.
What does the clinical picture depend on?
The clinical picture also depends on the localization, clinical stage, extension of the tumor and the type of cells affected by the malignant process. Here are just a few examples: malignant transformation of the G-cells of the stomach, duodenum or pancreas results in gastrinomas characterized by the secretion of gastrin, which stimulates the excessive production of gastric acid and the formation of gastric ulcers; the clinical picture of reduced blood sugar level (hypoglycemia) due to high insulin levels is characteristic of insulinomas resulting from the malignant growth of ß-cells of the pancreas; pheochromocytoma (adrenal medulla tumor) produces large amounts of the hormones adrenaline and noradrenaline, which causes attacks of high blood pressure, rapid heartbeat and sweating; some types of neuroendocrine tumors present with attacks of difficulty breathing and facial flushing, while the clinical picture of diarrhea is dominant in neuroendocrine tumors of the intestine.
How is the diagnosis made?
The diagnosis is established by a specialist examination, laboratory tests and diagnostic-instrumental tests (endoscopic tests such as gastroscopy, colonoscopy, bronchoscopy), taking a tumor sample by puncture and biopsy, hormonal tests, genetic analysis and radiological diagnostic methods such as imaging with CT, MR and PET. In the early stages of the disease, the treatment is surgical and in advanced stages specific oncological treatment is applied.