Pancreas Endocrine Tumors – Insulinoma, Gastrinoma, and Non-Functional NET
Pancreas endocrine tumors, also known as pancreatic neuroendocrine tumors (pNETs), are rare tumors that develop in the hormone-producing cells of the pancreas. These tumors may be functional, producing excess hormones, or non-functional, meaning they do not secrete hormones but can still grow and spread.
Types of Pancreas Endocrine Tumors
- Insulinoma Insulinomas are rare tumors that produce excessive insulin, leading to dangerously low blood sugar levels (hypoglycemia). These tumors are usually small and benign but can sometimes be malignant.
- Gastrinoma Gastrinomas secrete excess gastrin, a hormone that stimulates stomach acid production. This leads to Zollinger-Ellison syndrome, causing severe peptic ulcers, acid reflux, and diarrhea.
- Non-Functional Neuroendocrine Tumors (NETs) Unlike functional tumors, non-functional NETs do not produce excess hormones. They are often diagnosed at an advanced stage due to their silent growth and may cause symptoms due to mass effects on nearby organs.
Causes of Pancreas Endocrine Tumors
- Genetic FactorsInherited conditions like Multiple Endocrine Neoplasia Type 1 (MEN1) increase the risk of pNETs.
- Sporadic MutationsIn most cases, these tumors arise due to spontaneous genetic mutations with no clear hereditary link.
- Neuroendocrine Cell Growth Unregulated growth of neuroendocrine cells in the pancreas can lead to tumor formation.
Recognising the Symptoms of Pancreas Endocrine Tumors
Insulinoma Symptoms
Frequent low blood sugar (dizziness, sweating, confusion)
Hunger and irritability
Fainting or seizures in severe cases
Gastrinoma Symptoms
Severe acid reflux and heartburn
Multiple or recurring stomach ulcers
Chronic diarrhea and abdominal pain
Non-Functional NET Symptoms
Unexplained weight loss
Jaundice (yellowing of the skin and eyes)
Abdominal pain and bloating
Diagnosis of Pancreas Endocrine Tumors
- Blood Tests –Elevated insulin, gastrin, or other hormone levels help detect functional tumors.
- Imaging Tests – CT scans, MRI, and PET scans locate tumors and assess their spread.
- Endoscopic Ultrasound (EUS) – Provides detailed imaging of pancreatic tumors and allows for biopsy.
- Biopsy & Histopathology – Confirms the type and malignancy of the tumor.
Treatment Options for Pancreas Endocrine Tumors
For localised tumors, surgery is the preferred treatment. Depending on the tumor size and location, procedures like enucleation (removal of the tumor alone) or partial pancreatectomy may be performed.
- Somatostatin Analogues (e.g., Octreotide, Lanreotide) – Help control hormone secretion in functional tumors.
- Proton Pump Inhibitors (PPIs) – Reduce stomach acid in gastrinoma cases to prevent ulcers.
- Diazoxide or Everolimus – Used for insulinoma and advanced NETs to regulate hormone levels and slow tumor growth.
- Targeted drugs like sunitinib and everolimus help slow tumor progression in advanced cases.
- Chemotherapy may be used for aggressive or metastatic neuroendocrine tumors.
Outcomes of Treatment
- Improved symptom control and quality of life with appropriate.
- Higher survival rates for localised tumors with early surgical removal.
- Lifelong follow-ups are required to monitor recurrence and hormonal balance
Complications of Untreated Pancreas Endocrine Tumors
If left untreated, these tumors can lead to severe complications. Insulinomas may cause life-threatening hypoglycemic episodes, leading to seizures and unconsciousness. Gastrinomas can result in chronic ulcers, intestinal bleeding, and digestive complications. Non-functional NETs may grow undetected until they spread to the liver or other organs, significantly reducing treatment options.
Managing Pancreas Endocrine Tumors for Long-Term Health
Early detection and timely treatment are crucial for managing pancreatic endocrine tumors effectively. Regular monitoring through imaging and blood tests ensures that any tumor recurrence or progression is detected early.If experiencing symptoms like recurrent ulcers, unexplained weight changes, or persistent low blood sugar, consulting a specialist for diagnostic testing is essential for prompt intervention and improved outcomes.