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Endocrine glands produce chemical agents, known
as hormones. These play a crucial role in the regulation of various
bodily functions.
Hormones carry important cellular information.
E.g. insulin enables glucose to migrate from bloodstream into cells
whereas thyroid glands influence the person`s activity level. A complicated
regulatory mechanism ensures that hormone levels in a healthy individualīs
bloodstream match requirements of day-to-day living. If hormone producing
cells are damaged, too little or too much of the substance will be generated
and the regulatory mechanism will start to malfunction.
Environmental influences and genetic alterations can
lead to malignant changes in hormone producing cells and to uncontrolled
growth, however without malignant virulence.
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Endocrine
tumors of the pancreas
a. The Insulinom
The insulinom is the main pancreatic hormone-producing tumor. Insulin
production without an inhibiting regulatory mechanism is a direct consequence
of this tumor. Not enough glucose can remain in the bloodstream which
leads to such well-known symptoms as outbreak of sweat, shaking, heart
pounding, weakness, impaired vision, anxiety, agressivity, and at worst
unconsciousness. Patients often become overweight when they discover
that these symptoms disappear with the intake of food. When fasting,
signs of an unusual lack of blood sugar are found. Locating these tumors
can be very difficult as they are usually small and several tumors can
exist. An effective therapy will seek to remove the tumor(s) from the
pancreas. If metastases are present and cannot be removed directly,
chemotherapy is necessary.
b. The Gastrinom
The gastrinom is another common form of a hormone-producing tumor. It
will often be found in the pancreas (80% of cases), however other organs
can also be affected (stomach, duodenum). Often malignant, this tumor
can produce metastases at an early stage. Patients suffer from stomach
and intestinal ulcers generated by the gastrin hormone. Usually these
can not be influenced by medication. Gastrin triggers the production
of stomach acid. The surgeon will attempt to remove the tumor, and if
metastases are found, an attempt to alleviate symptoms with acid-inhibiting
medication will be made. In earlier times, the patientīs stomach was
removed to prevent further formation of ulcers, as stomach acid production
will cease with the removal of the organ.
c. VIPom und Glucagonom
VIPom and glucagonom are rare tumors. Usually they are found in or near
the pancreas. Glucagonom and diabetes mellitus share a set of similar
symptoms, such as elevated blood sugar levels. Patients also suffer
from alterations of skin appearance. The Vermer-Morrison-syndrome is
present If an endocrine tumor leads to the production of VIP (vasoactive
intestinale polypeptid). This hormone triggers secretion in the small
intestine and in the pancreas and leads to watery diarrhoea, potassium-salt
and chloride deficiencies in the secretion of the stomach-intestinal
system. The patient suffers from excessive acidic saturation. In any
such case it is difficult to identify and locate the tumor. Even small
tumors generate metastases at a very early stage, a fact which necessitates
chemotherapy as well as habitually administered treatments.
d. Other Endocrine Tumors
Some endocrine tumors will not produce
any measurable hormone quantities, which often makes detection difficult.
Growth characteristics and metastases production set these tumors apart
from the common carcinome found in the pancreatic duct. Different surgical
procedures and different radiation therapy / chemotherapy approaches
are needed.
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