Pancreating Neuroendocrine Tumors can be difficult to diagnose and treat. The cells of the pancreatic islet usually produce hormones such as insulin that regulate metabolism. When these cells grow abnormally, they can cause a number of health problems. Not all islet cell tumors produce hormones; ones that do not are called “non-functional” tumors.

Types of PNETs:

• Gastrinomas
• Glucagonomas
• Insulinomas
• VIP-omas
• Non-functional tumors

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These tests can help diagnose PNETs/islet cell tumors:

• Physical exam and history
• CT Scan
  
• MRI
  
• Octreoscan
• Blood chemistry studies: A blood sample is checked for certain substances released into the blood by organs, tissues or tumor cells
• Immunohistochemistry study: Cancer tissues are tested for certain antigens
• Abdominal CT scan (CAT scan)
• Somatostatin receptor scintigraphy: Radionuclide scan used to find islet cell tumors
• Abdominal ultrasound:Ppictures are made of the inside of the abdomen with an ultrasound
• Endoscopic ultrasound (EUS): A thin, tube-like tool is inserted through the mouth or rectum to look at tissues inside the body
• ERCP (endoscopic retrograde cholangiopancreatography): An X-ray image of the tubes that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine
• Angiogram: Contrast dyes are injected and move through the blood vessels to take X-rays in search of any blockages
• Laparotomy: A surgical procedure making a small incision in the abdomen wall checking for signs of disease
• Intraoperative ultrasound: Images of internal organs and tissues are made during surgery
• Biopsy
  

Islet cell tumors and PNETs may cause some of these symptoms, but other conditions may cause the same symptoms.

These kinds of tumors may grow large or spread to other areas in the body before symptoms occur. See a doctor if you have any of these problems:

• Diarrhea
• Indigestion
• Lump in the abdomen
• Pain in the abdomen or back
• Yellowing of the skin and whites of the eyes

Symptoms for a functional islet tumor depend on the type of hormone being produced.

Too much gastrin may cause:

• Chronic stomach ulcers
• Pain in the belly, which may spread to the back. The pain may come and go and it may go away after taking an antacid
• The flow of food in the stomach back into the esophagus (gastroesophageal reflux)
• Diarrhea

Too much insulin may cause:

• Low blood sugar
• Feeling a fast heartbeat

Too much glucagon may cause:

• Skin rash on the face, stomach or legs
• High blood sugar
• Blood clots in the lung
• Diarrhea
• Unexplained weight loss
• Sore tongue or sores at the corners of the mouth

Too much vasoactive intestinal peptide (VIP) may cause:

• Large amounts of watery diarrhea
• Dehydration
• Low potassium level in the blood
• Cramps or pain in the belly
• Unexplained weight loss

Too much somatostatin may cause:

• High blood sugar
• Diarrhea
• Steatorrhea (very foul-smelling stool that floats)
• Gallstones
• Yellowing of the skin and whites of the eyes
• Weight loss for no known reason

Treatment often involves surgery. Unless the disease is widely metastatic (spread to other areas of the body), it often requires removing part of the pancreas. Sometimes, if the tumor is very small, it can be removed without taking out large pieces of the pancreas.

If you are diagnosed with this kind of cancer, talk to your doctor about joining a clinical trial to help improve treatment.

• Smoking
• Long-standing diabetes
• Chronic pancreatitis
• Having multiple endocrine neoplasia type 1 syndrome