Italian Association of Clinical Endocrinologists (AME) position statement: a stepwise clinical approach to the diagnosis of gastroenteropancreatic neuroendocrine neoplasms.

Abstract

Why this document Neuroendocrine neoplasms (NENs) can arise almost throughout the entire body and share common morphological, ultrastructural, and immunohistochemical characteristics. Neuroendocrine neoplasms are an emerging entity that can occur at any age, with the median age at diagnosis in the late fifth decade and an age-related incidence increase. About two-thirds involve the gastro-entero-pancreatic (GEP) tract and epidemiological studies show their increasing incidence [1]. In the last decades, the overall reported incidence of GEP-NENs increased from 1.0 to 5.25/100.000 persons/year, with a present estimated prevalence of 35/100.000 [1–10]. Physicians’ awareness, endoscopic screening and increased sensitivity of diagnostic tools may at least in part explain this growing trend. Most guidelines are focused on staging, treatment and follow-up of NENs. However, an appropriate clinical suspicion and a correct diagnostic work-up are critical starting points. A multidisciplinary approach, moreover, is crucial to provide a timely and integrated care. Hence, this document is neither a review, nor a guideline; rather, it is a clinical guide for a stepwise and integrated diagnostic work-up of GEP-NENs. Hopefully, this will result in a correct utilization of resources and optimization of the cost/benefit ratio.