 Neuroendocrine tumor in the tail of the pancreas, removed laparoscopically. |
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What is a neuroendocrine tumor (NET) of the pancreas?
Cells that have both a “neural component i.e. receive messages via a nerve” and an “endocrine component i.e. respond by releasing a hormone”- are called neuroendocrine cells. The pancreas and a few other organs have a relative abundance of neuroendocrine cells. This is a very rare tumor of the pancreas and only 1-2% of pancreatic tumors are neuroendocrine in origin. Over 90% of the pancreatic cancers are adenocarcinomas.
There are 2 distinct types of NET tumors:
1. Pancreatic endocrine tumors (PET), also know as “Endocrine tumors of the Pancreas” or “Islet Cell Tumors of the Pancreas”. Islet cells are the hormone producing cells within the pancreas. 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);
2. Carcinoid tumors, which were first described in 1907 by Siegfried Oberndorfer. The term "carcinoid" means "cancer-like" and are cancerous, except very slow-growing. A carcinoid tumor is often associated with an increased production of serotonin (5-HT), a chemical transmitter that causes a specific set of symptoms including flushing, diarrhea, weight loss, heart palpitations etc. This set of symptoms is called “carcinoid syndrome”. Carcinoid tumors can also arise in lung, thymus, stomach, duodenum, small bowel, colon and rectum. Less than one percent of carcinoid tumors originate in the pancreas.
What is the treatment for these tumors?
The key is localization of the tumor and then surgical excision. Localization involves a high resolution CT scan or 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:
Related Links:
Islet Cell Tumors
Endocrine Tumors of the Pancreas
Pancreatic Cancer |