Pancreatic Neuroendocrine Tumor


Pancreatic Neuroendocrine Tumor Definition

Pancreatic neuroendocrine tumor abbreviated as NET/NETs which are also known as islet cell tumors are growths that could either be benign or malignant. NETs grow in the pancreas from islet cells. These cells are accountable for the making and releasing of different kinds of hormones directly into the bloodstream. The growth may lead to an overproduction of some hormones.

Pancreatic Neuroendocrine Tumor


An islet tumor is not common but it could cause several symptoms depending on the kind of hormone that is produced. If the growth is cancerous and spreads to other body parts, the cancer may become very severe.

There are two types of NETs and these are:

Functional tumors

The tumors produce hormones that lead to symptoms. Functional tumors are classified into three and these are:


  • Gastrinoma – This happens when the tumor from the islet cells that creates the hormone gastrin grows.
  • Insulinoma – This tumor produces the insulin hormone.
  • Glucagonoma – This tumor produces the glucagon hormone.

Other rare types of functional tumors are VIPomas; which creates vasoactive intestinal peptide and somatostatinomas, that produces somatostatin hormone and are responsible for controlling salt, sugar, and water levels in the body.

Nonfunctional tumors

The tumors manufacture certain substances that do not cause any symptoms. The symptoms only occur when the tumor spreads or gets bigger. These tumors are usually cancerous.


Symptoms of Pancreatic Neuroendocrine Tumor

The symptoms of pancreatic neuroendocrine tumors depend on the type. Some growths do not cause any symptoms.

Symptoms of nonfunctioning tumors appear from the spread and growth of the tumor and these include:

  • Indigestion
  • Abdominal or back pain
  • Diarrhea
  • Yellowish discoloration of the whites of the eyes and skin

Symptoms of functioning tumors vary on the amount of hormone produced and released in the bloodstream.

Excess amount of gastrin could cause:

  • Diarrhea
  • Ulcers of the stomach that keeps recurring
  • Gastroesophageal reflux wherein the contents of the stomach flows back in the esophagus
  • Abdominal and/or back pain that might come and go after the intake of antacid

Excess amount of insulin could cause:

  • Rapid beating of the heart
  • Low blood sugar

This symptom may be an outcome of frequent urinating, weakness, blurred vision, dryness of skin and mouth, thirst, or hunger.

Excess amount of glucagon could cause:

  • Diarrhea
  • Losing of weight without any reasons
  • Skin rash that may be present on the legs, face, or stomach
  • Sore tongue
  • Sores at the region around the mouth
  • High blood sugar

This symptom can be a result of frequent urination, hunger, thirst, tiredness, dryness of skin and mouth, or headaches.

Blood clots within the lung

This symptom can be a result of pain, inflammation, or redness of the leg or arm, and respiratory problems.

Staging

Staging is a term used in describing the extent of the spreading of the cancer. The stages of the pancreatic cancer are:


Stage 0: No spread

The cancer is still on the single layer of cells inside the pancreas and is not yet visible to the naked eye or to any imaging tests.

Stage I: Local growth

The tumor is restricted in the pancreas, but has grown for about 2 centimeters or less (stage IA) or bigger than 2 centimeters (stage IB).

Stage II: Local spread

The tumor has grown outside of the pancreas, or perhaps spread to lymph nodes close by.

Stage III: Wider spread

The tumor has grown into major blood vessels or nerves close by but have not spread to other sites in the body.

Stage IV: Confirmed spread

The tumor has spread to remote organs.

Treatment

There are various types of treatment for patients with pancreatic neuroendocrine tumors. These include:

Medications

If the tumor is non-cancerous, which typically occurs in a functional tumor, medications can treat the symptoms of the excessive hormone production.

Surgery

Most malignant tumors are treated by surgery including Islet cell tumors. The main motive of surgical treatment is to remove the tumor as much as possible. Some tumors may have spread to other areas of the body, but it could still be removed through surgery.

Chemotherapy

This is recommended by the physician when the cancer cells had spread all throughout the body in order to decrease the tumor’s size.

Prognosis

If a malignant tumor is discovered before it had spread further away from the pancreas or if the tumor is benign, then the prognosis is good. Once the cancer cells have spread on other areas of the body, the chance of recovering is lessened.

Survival Rate

There is about 55% chance of 5-year survival after diagnosis when the tumors are resected and localized, but only 15% chance of survival when the tumors cannot be removed. Overall 5-year survival rate is approximately 42%.

References

  1. http://my.clevelandclinic.org/health/diseases_conditions/hic-pancreatic-cancer/hic_Islet_Cell_Carcinoma_Endocrine_Pancreas
  2. http://www.webmd.com/cancer/pancreatic-cancer/pancreatic-cancer-treatments-stage
  3. http://www.healthline.com/health/pancreatic-islet-cell-tumor#Symptoms4
  4. Warner RR, Curran T, Shafir MK, et al (2011 May). Serum and ascites chromogranin-A in patients with metastatic neuroendocrine tumors. Pancreas. 40(4):622-6.
  5. Naswa N, Sharma P, Kumar A, et al (2011 Nov). Gallium-68-DOTA-NOC PET/CT of patients with gastroenteropancreatic neuroendocrine tumors: a prospective single-center study. AJR Am J Roentgenol. 197(5):1221-8.
  6. Nasir A, Helm J, Turner L, et al (2011 May). RUNX1T1: a novel predictor of liver metastasis in primary pancreatic endocrine neoplasms. Pancreas. 40(4):627-33.

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