[Inherited tumor syndromes of gastroenteropancreatic and thoracic neuroendocrine neoplasms]

Ann Pathol. 2020 Apr;40(2):120-133. doi: 10.1016/j.annpat.2020.01.002. Epub 2020 Feb 5.
[Article in French]

Abstract

About 5% of gastroenteropancreatic and thoracic neuroendocrine neoplasms (NENs) arise in the context of an inherited tumour syndrome. The two most frequent syndromes are: multiple endocrine neoplasia type 1 (MEN1), associated with a large spectrum of endocrine and non endocrine tumours, including duodenopancreatic, thymic and bronchial NENs, and the von Hippel-Lindau syndrome VHL, associated with pancreatic NENs. Two inherited syndromes have a low incidence of NENs: neurofibromatosis type 1 (NF1), associated with duodenal somatostatinomas, and tuberous sclerosis (TSC), associated with pancreatic NENs. Two rare syndromes have a high incidence of NENs: multiple endocrine neoplasia type 4 (MEN4), with a tumour spectrum similar to that of MEN1, and glucagon cell hyperplasia neoplasia (GCHN), involving only the pancreas. It is likely that other syndromes remain to be characterized, especially in familial small-intestinal NENs. The diagnosis is usually raised because of the suggestive clinical setting: young age at diagnosis, multiple tumours in multiple organs, familial history. Except in VHL and NF1, tumours themselves do not show specific pathological features; they usually are well differentiated and of low histological grade; their prognosis is good, except for MEN1-associated thymic NENs. The most suggestive pathological feature is their combination with various endocrine and/or non endocrine lesions in the adjacent tissue. Pathological examination is important, for a correct diagnosis and for an accurate management of the patients and their families, who must be referred to expert centers.

Keywords: MEN1; MEN4; NEM1; NF1; Neuroendocrine neoplasms; Syndrome VHL; TSC; Tumeurs neuroendocrines; VHL syndrome.

Publication types

  • Review

MeSH terms

  • Duodenal Neoplasms / diagnosis
  • Genetic Predisposition to Disease
  • Humans
  • Intestinal Neoplasms / complications
  • Intestinal Neoplasms / diagnosis
  • Intestinal Neoplasms / genetics
  • Intestinal Neoplasms / pathology
  • Intestines / pathology
  • Multiple Endocrine Neoplasia / complications
  • Multiple Endocrine Neoplasia / diagnosis
  • Multiple Endocrine Neoplasia / genetics
  • Multiple Endocrine Neoplasia / pathology
  • Multiple Endocrine Neoplasia Type 1 / complications
  • Multiple Endocrine Neoplasia Type 1 / diagnosis
  • Multiple Endocrine Neoplasia Type 1 / genetics
  • Multiple Endocrine Neoplasia Type 1 / pathology
  • Neoplastic Syndromes, Hereditary* / complications
  • Neoplastic Syndromes, Hereditary* / diagnosis
  • Neoplastic Syndromes, Hereditary* / pathology
  • Neuroendocrine Tumors / complications
  • Neuroendocrine Tumors / diagnosis
  • Neuroendocrine Tumors / genetics
  • Neuroendocrine Tumors / pathology*
  • Pancreas / pathology
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / genetics
  • Pancreatic Neoplasms / pathology
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / pathology
  • Thoracic Neoplasms / diagnosis
  • Thorax / pathology
  • Tuberous Sclerosis / etiology
  • Tuberous Sclerosis / pathology
  • von Hippel-Lindau Disease / complications
  • von Hippel-Lindau Disease / diagnosis
  • von Hippel-Lindau Disease / genetics
  • von Hippel-Lindau Disease / pathology

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor
  • Multiple Endocrine Neoplasia, Type IV