 Endocrine tumor in the body and tail of the pancreas removed in it’s entirety with a distal pancreatectomy operation performed laparoscopically. |
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What are endocrine tumors of the pancreas?
The pancreas gland has two important functional components. First, it is responsible for the production of digestive juices (exocrine function); second, it is responsible for the production of hormones such as insulin, glucagon, somatostatin etc (endocrine function). Cancers arising from the hormone-producing component of the pancreas are referred to as endocrine tumors of the pancreas. One of the commonest tumor types is referred to as an insulinoma. These patients typically have excess insulin production leading to sudden drops in their sugar levels presenting as fainting spells. These can be diagnosed with specialized blood tests and often identified by a good quality high resolution CT scan or MRI scan. Endocrine tumors can be non-cancerous (benign) or cancerous (malignant). The diagnosis of benign versus malignant can often only be made after the tumor has been surgically removed.
What are islet cell tumors of the pancreas?
Islet cells are the hormone producing cells within the pancreas. Tumors arising from this cell type are referred to as islet cell tumors. These tumors are also often called neuroendocrine tumors. There are several subtypes of islet cells, the commonest being, Alpha cells producing glucagon (15% of total islet cells), Beta cells producing insulin and amylin (75%), Delta cells producing somatostatin (3-5%), PP cells producing pancreatic polypeptide (3-5%), Epsilon cells producing ghrelin. (<1%).
Islet cell tumors can be functional (as in secrete excess hormones in to the body) or non-functional (do not secrete hormones).
What is the treatment for these tumors?
The key is localization of the tumor and then surgical excision. Localization involves a high resolution computerised tomography (CT) scan or Magnetic Resonance Imaging (MRI) with very fine slices. At the Liver and Pancreas Center we perform this scan with a specialized “Pancreas Protocol” with multiple phases. Octreotide scans, Portal Venous Sampling, Intra-operative Ultrasound are occasionally indicated and are used as deemed necessary. Experience of the surgeon is a key factor and we offer several surgical options for removing the tumor. These include:
Our preferred approach to removing these tumors is laparoscopic/robotic , but the open route may be necessary depending on the size and location of the tumor.
Related Links:
Islet Cell Tumors?
Can it be done Laparoscopically?
Neuroendocrine Tumors?
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