Pancreatic endocrine tumors.
Incidental, nonfunctional pancreatic endocrine tumors (PET) are observed with increasing frequency. Most are insulinomas. Endoscopic ultrasound with fine-needle aspiration plays a significant role in the localization and tissue diagnosis of PET. Establishing PET behavior as aggressive or indolent remains challenging especially preoperatively. Newer techniques including DNA and micro-RNA analysis may play a role in this arena. Small benign PET may be enucleated or removed laparoscopically. Surgery is the mainstay of treating advanced disease including those with metastases and Zollinger-Ellison syndrome. The management of multiple endocrine neoplasia type 1 continues to be a challenge, including treating symptoms, targeted resections, and close observation. Diagnosis, management, and prognostication of PET are under evolution and a number of changes in these fronts are anticipated.
Jani
Niraj
N
The Department of Medicine, The University of Pittsburgh Medical Center, 200 Lothrop Street, Mezz Level C, PUH, Pittsburgh, PA, USA.
Moser
A James
AJ
Khalid
Asif
A
D003937:Diagnosis, Differential; D006801:Humans; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011379:Prognosis