Pancreatic Neuroendocrine Tumors

Anatomy and Physiology

The pancreas is an oblong gland about 6 - 8 inches in length, which lies beneath the stomach. The pancreas has two separate functions: the exocrine portion (about 80% of the gland) which secretes enzymes important for the digestion of food and the endocrine portion which secretes several hormones including insulin, glucagon, somatostatin, and pancreatic polypeptide.

There are many diseases of the exocrine pancreas such as pancreatitis and pancreatic adenocarcinoma. These diseases will not be discussed here.

Pancreatic Neuroendocrine Tumors

Any of the cells which secrete hormones may be transformed into a tumor which over-secretes the hormone. The tumors are named based on the hormone it produces such as glucagonoma, insulinoma, gastrinoma, and somatostatinoma. These tumors can produce a wide range of symptoms related to the excessive hormone production. Endocrine pancreatic tumors can also arise which do not secrete any of these hormones. Occasionally, these tumors are inherited with other tumors in the Multiple Endocrine Neoplasia (MEN) type 1 syndrome. Most pancreatic endocrine tumors require surgical resection, with an integrated approach by the endocrine surgeon, medical endocrinologist, radiologist and gastroenterologist.

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