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Pancreatic Neuroendocrine Tumors
Umesh D. Oza, MD; Paige Bennett, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Definitions

          • Pancreatic neuroendocrine tumor (panNET)
            • Arise from pancreatic endocrine cells (islets of Langerhans)
            • Also called islet cell tumors
            • Can secrete hormones (e.g., insulin, gastrin, glucagon, vasoactive intestinal peptide) or be nonfunctioning
            • Rare compared with exocrine pancreatic tumors
            • Benign or malignant, single or multiple presentations
            • Express somatostatin receptors

        IMAGING

        • General Features

          • CT Findings

            • Angiographic Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. ACR Practice Parameter for the Performance of Gallium-68 Dotatate PET/CT for Neuroendocrine Tumors. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/DOTATATE_PET_CT.pdf. Accessed April 30, 2020
                                      2. Lee L et al: Imaging of pancreatic neuroendocrine tumors: recent advances, current status, and controversies. Expert Rev Anticancer Ther. 18(9):837-60, 2018
                                      3. Sadowski SM et al: Prospective study of 68Ga-DOTATATE positron emission tomography/computed tomography for detecting gastro-entero-pancreatic neuroendocrine tumors and unknown primary sites. J Clin Oncol. 34(6):588-96, 2016
                                      4. Mansi L et al: Diagnostic imaging in neuroendocrine tumors. J Nucl Med. 55(10):1576-7, 2014
                                      5. Herwick S et al: MRI of islet cell tumors of the pancreas. AJR Am J Roentgenol. 187(5):W472-80, 2006
                                      6. Noone TC et al: Imaging and localization of islet-cell tumours of the pancreas on CT and MRI. Best Pract Res Clin Endocrinol Metab. 19(2):195-211, 2005
                                      7. Dromain C et al: MR imaging of hepatic metastases caused by neuroendocrine tumors: comparing four techniques. AJR Am J Roentgenol. 180(1):121-8, 2003
                                      8. Krausz Y et al: Somatostatin-receptor scintigraphy in the management of gastroenteropancreatic tumors. Am J Gastroenterol. 93(1):66-70, 1998
                                      9. van Eijck CH et al: The use of somatostatin receptor scintigraphy in the differential diagnosis of pancreatic duct cancers and islet cell tumors. Ann Surg. 224(2):119-24, 1996
                                      10. Becker W et al: Octreotide scintigraphy localizes somatostatin receptor-positive islet cell carcinomas. Eur J Nucl Med. 18(11):924-7, 1991
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Definitions

                                              • Pancreatic neuroendocrine tumor (panNET)
                                                • Arise from pancreatic endocrine cells (islets of Langerhans)
                                                • Also called islet cell tumors
                                                • Can secrete hormones (e.g., insulin, gastrin, glucagon, vasoactive intestinal peptide) or be nonfunctioning
                                                • Rare compared with exocrine pancreatic tumors
                                                • Benign or malignant, single or multiple presentations
                                                • Express somatostatin receptors

                                            IMAGING

                                            • General Features

                                              • CT Findings

                                                • Angiographic Findings

                                                  • MR Findings

                                                    • Ultrasonographic Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • Staging, Grading, & Classification

                                                            • Gross Pathologic & Surgical Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. ACR Practice Parameter for the Performance of Gallium-68 Dotatate PET/CT for Neuroendocrine Tumors. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/DOTATATE_PET_CT.pdf. Accessed April 30, 2020
                                                                          2. Lee L et al: Imaging of pancreatic neuroendocrine tumors: recent advances, current status, and controversies. Expert Rev Anticancer Ther. 18(9):837-60, 2018
                                                                          3. Sadowski SM et al: Prospective study of 68Ga-DOTATATE positron emission tomography/computed tomography for detecting gastro-entero-pancreatic neuroendocrine tumors and unknown primary sites. J Clin Oncol. 34(6):588-96, 2016
                                                                          4. Mansi L et al: Diagnostic imaging in neuroendocrine tumors. J Nucl Med. 55(10):1576-7, 2014
                                                                          5. Herwick S et al: MRI of islet cell tumors of the pancreas. AJR Am J Roentgenol. 187(5):W472-80, 2006
                                                                          6. Noone TC et al: Imaging and localization of islet-cell tumours of the pancreas on CT and MRI. Best Pract Res Clin Endocrinol Metab. 19(2):195-211, 2005
                                                                          7. Dromain C et al: MR imaging of hepatic metastases caused by neuroendocrine tumors: comparing four techniques. AJR Am J Roentgenol. 180(1):121-8, 2003
                                                                          8. Krausz Y et al: Somatostatin-receptor scintigraphy in the management of gastroenteropancreatic tumors. Am J Gastroenterol. 93(1):66-70, 1998
                                                                          9. van Eijck CH et al: The use of somatostatin receptor scintigraphy in the differential diagnosis of pancreatic duct cancers and islet cell tumors. Ann Surg. 224(2):119-24, 1996
                                                                          10. Becker W et al: Octreotide scintigraphy localizes somatostatin receptor-positive islet cell carcinomas. Eur J Nucl Med. 18(11):924-7, 1991