Endocrine Abstracts

Patients with small bowel NET may present in a different way from other GPNET patients, with well-established disease and metastases. They may have long term symptoms that are well investigated but remain undiagnosed sometimes for years. To examine this supposition the presenting symptoms and outcomes of the first thirty patients with small bowel NET seen in 2018 were examined. Of these thirty patients eight were female and twenty-two were male with a median age of 64.5 years (range 48.5 to 75.6 years). Fourteen patients had their disease discovered incidentally (two at bowel resection). Six had a bowel resection (two now with nodal recurrence, four no recurrence) and eight no resection. Of the eight who did not have a bowel resection one died soon after, the remainder having stable disease on SSA injections. Seven patients presented acutely with abdominal pain (3), bleeding (1), bowel perforation (2), or obstruction (1). This led to four Right Hemicolectomies, two small bowel resections and one ileostomy (who died). Two patients have no recurrent disease on surveillance. The four remaining all have metastatic disease. Three patients are stable on SSA. The third category is six patients who had long term symptoms, of anaemia (1), weight loss (2) or abdominal pain (3). This type of patient is that thought may be undiagnosed for a long period of time, presenting with advanced disease. The patient with anaemia had a number of investigations before diagnosis. One patient had precipitous weight loss over weeks, the other over two years. Three patients presented with abdominal pain (two also with weight loss) and had a small bowel resection. The pain symptom was present for either years (2) or a few weeks (1). One died from slowly progressing disease, the others show no sign of disease recurrence. In the final category of three patients the original histological diagnosis was made between two and seven years ago. There is little information available concerning presentation and symptoms so little inference can be drawn. It would appear that patients presenting with well-established disease and metastases and long term symptoms may not be as common as historically.