Pancreatic Neuroendocrine Tumor (Pancreatic NETs)

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Treating pancreatic neuroendocrine tumors at Scripps Health

Pancreatic neuroendocrine tumors (also called Islet cell tumors, Islet of Langerhans tumors or pancreatic NETs) are tumors that form in islet cells of the pancreas and can be benign or malignant. There are two types of pancreatic neuroendocrine tumors:


  • Gastrinoma (also known as Zollinger-Ellison syndrome).
  • Glucagonoma (also known as insulinoma), of which more than 90 percent of the tumors are benign.

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Detection and diagnosis of pancreatic NETs

Tests and exams performed to detect and diagnose pancreatic neuroendocrine tumors may include:


  • Blood chemistry studies.
  • Chromogranin A test to check the amount of chromogranin A in the blood. A higher than normal amount can signal the presence of a pancreatic neuroendocrine tumor.
  • Somatostatin receptor scintigraphy (also called octreotide scan and SRS), which is a type of radionuclide scan used to find small pancreatic neuroendocrine tumors through the use of a small amount of radioactive hormone (octreotide). The hormone attaches to tumors and can be detected by a special camera that captures radioactivity .
  • Endoscopic ultrasound (EUS) that combines use of an endoscope and high-energy sound waves (ultrasound) to create a medical image known as a sonogram.
  • Endoscopic retrograde cholangiopancreatography (ERCP), in which dye is injected into the bile ducts and captured with an X-ray to check for blockage and any abnormal growths. An endoscope and catheter are used in the procedure as well as a stent to unblock a duct.
  • Laparotomy (also known as abdominal exploration), a procedure in which an incision is made in the wall of the abdomen to check for signs of disease. The size of the incision depends on the reason the laparotomy is being done. Sometimes organs are removed or tissue samples are taken and checked under a microscope for signs of disease.
  • Intraoperative ultrasound, which is a procedure that uses high-energy sound waves to create images of organs or tissues during surgery.

Treatment of pancreatic neuroendocrine tumors

Treatment options for pancreatic neuroendocrine tumors may include:

Surgery

  • Enucleation (surgical removal) of the tumor only when cancer is confined to one place in the pancreas.
  • Pancreatoduodenectomy (also known as the Whipple procedure) to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine and bile duct.
  • Distal pancreatectomy to remove the body and tail of the pancreas, as well as possibly the spleen.
  • Total gastrectomy to remove the entire stomach.
  • Parietal cell vagotomy that cuts the vagus nerve to reduce the secretion of acid to the stomach.
  • Radiofrequency ablation that uses a probe and electrodes to eliminate cancer cells. The probe may be inserted directly through the skin of the abdomen or through an incision.
  • Cryosurgical ablation (also known as cryoablation) that uses liquid nitrogen or liquid carbon dioxide to freeze and eliminate abnormal cells. It may be done during traditional or minimally invasive surgery.

Chemotherapy

Chemotherapy drugs can be used alone or in combination with other treatments to slow the growth of pancreatic neuroendocrine tumors.

Hormone therapy

Hormone therapy can be used to remove or block hormones and stop cancer cells from growing.

Hepatic arterial occlusion or chemoembolization

Hepatic arterial occlusion stops or restricts the flow of blood to the liver through the major blood vessel that carries blood to the liver. Chemotherapy is sometimes given during the procedure and the process is known as chemoembolization.

Targeted therapy

Targeted therapies are currently being investigated by studies as a way to attack tumor cells without harming healthy tissue.

Support services

To enhance the care of people dealing with pancreatic neuroendocrine tumors, Scripps Health also offers patient support services.