We conducted a retrospective search of 16 consecutive patients with pancreatic neuroendocrine tumor (pNET).
Information about 13 cases of pancreatic NET patients was obtained from the pathology databases of the Hospital Universitario de Móstoles (Madrid,
Spain) for the period between 2011 and 2018.
The other 3 cases are patients with suggestive image findings of pNET but not confirmed by anatomy pathology yet.
The following clinical parameters were assessed from the medical records: age,
gender,
medical history,
the presence of tumor-related symptoms (i.e.,
abdominal pain),
the presence of clinical symptoms caused by excess hormone secretion (i.e.,
diarrhea,
hypoglycemic episodes).
Radiological findings were also reviewed to obtain information pertaining to tumor size,
location within the pancreas (head,
body,
or tail),
and metastatic site.
-Results:
-Type of pNET: gastrinoma: 1 case; insulinoma; 4 cases; nonsyndromic pNET: 12 cases (one patient with MEN1 has both gastrinoma and insulinoma).
-Age: 33-81-year-old (average of age: 66-year-old).
-Gender: Female: 7 cases; Male: 9 cases (Fig. 13).
Fig. 13: Types of pNETs and epidemiology in our study
-Past medical history: DM: 4 cases; MEN-1: 1 case; none: 10 cases.
-Symptomatology of presentation: Abdominal pain: 2 cases; constitution syndrome: 3 cases; hypoglycemia: 3 cases; asymptomatic: 7 cases (Fig. 14)
Fig. 14: Past medical history and symptomatology of presentation
-Imaging findings: well defined enhancing lesion: 12 cases; heterogeneous lesion: 1 case; cystic lesion: 1 case.
-Localization: pancreatic head: 7 cases; pancreatic body: 4 cases; pancreatic tail: 5 cases.
-Number: unique lesion: 15 cases; multiple lesions: 1 case.
-Size: 1,4-7 cm (average size: 3,2 cm).
-Metastases: 4 cases.
-Exitus: 2 cases (Fig. 15).
Fig. 15: Imaging findings and pancreatic mimics of pNET in our institution.
However,
pNET mimics has also to be considered.
In the same period,
we observed 4 pancreatic lesions with similar imaging findings of pNET.
-3 cases of pancreatic metastases: all three primary cancers were renal cell carcinoma (RCC) many years after their diagnosis (more than 10).
-1 case of intrapancreatic splenule.
Thus in our institution,
a considerable percentage (4 out of 20 cases) of imaging suspects of pNETs were finally not (20% of false positives with image techniques).