Endocrine tumours of the pancreas
Endocrine tumours of the pancreas comprise tumours which arise from the pancreatic islet cells and include a number of distinct tumours which match the cell type of origin. Each has different clinical presentation, on account of them elaborating various hormones and different biological behaviours.
These tumours can be divided according to whether or not they secrete active compounds. They are:
- functional tumours : 85%
- insulinoma : most common
- gastrinoma
- glucagonoma
- VIPoma
- somatostatinoma
- non-functional tumours : 15%
Individual functional tumours are discussed in more details separately. Below is a general discussion focusing on non-functioning tumours
Epidemiology
Tumours can be isolated or associated with the multiple endocrine neoplasia type I (MEN I), which is characterized by the triad of parathyroid, pituitary, and pancreatic lesions.
Clinical presentation
Functional tumours tend to present earlier, with clinical signs and symptoms related to their cell type.
- insulinoma : Whipple's triad
- gastrinoma : Zollinger-Ellison syndrome
- glucagonoma : glucagonoma syndrome
- non-functioning tumours : tend to present late, similar to pancreatic adenocarcinomas
Radiographic features
Multiphase contrast enhanced thin slice cross-sectional imaging is ideal. Tumours tend to be smaller and hypervascular and may be calcified, and may be cystic.
Content pending.
Treatment and prognosis
If diagnosed early enough then complete surgical resection can be curable. Biological behaviour also depends on cell of origin:
- insulinoma : 10% malignant
- gastrinoma : 60% malignant
- glucagonoma : 80% malignant
- VIPoma : 75% malignant
- somatostatinoma : 75% malignant
- non-functional : 85 - 100% malignant

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