PANCREATIC NEUROENDOCRINE TUMORS: SURGICAL RESECTION

• Published in: Arquivos brasileiros de cirurgia digestiva : ABCD Vol. 32; no. 1; p. e1428
• Main Authors: Belotto, Marcos, Crouzillard, Bruna do Nascimento Santos, Araujo, Karla de Oliveira, Peixoto, Renata D'Alpino
• Format: Journal Article
• Language: English
• Published: Brazil Colégio Brasileiro de Cirurgia Digestiva 01.01.2019
• Subjects: Neuroendocrine tumor; Pancreas; Pancreatic neoplasm; Review
• ISSN: 0102-6720; 2317-6326
• DOI: 10.1590/0102-672020180001e1428

Pancreatic neuroendocrine tumors (pNET) correspond to about 3% of all tumors in pancreas and could be presented as a difficult diagnosis and management. To review the diagnosis and treatment of the pNET available in scientific literature. A bibliographic survey was performed by means of an online survey of MeSH terms in the Pubmed database. A total of 104 articles were published in the last 15 years, of which 23 were selected as the basis for the writing of this article. pNET is an infrequent neoplasia and their incidence, in USA, is about 1:100.000 inhabitants/year. Thereabout 30% of them produce hormones presenting as a symptomatic disease and others 70% of the cases could be silent disease. Magnetic Resonance Imaging (MRI) and/or Computed Tomography (CT) have similar sensitivy to detect pNET. They are very important when associated to nuclear medicine mainly Positron Emission Tomography (PET-CT) Gallium-68 to find primary tumor and its staging. The appropriate treatment should be chosen based on characteristics of the tumor, its staging and associated comorbidities. The surgical resection is still the best treatment for patients with ressectable pancreatic NETs. However, the size, grade, tumor functionality, stage and association with multiple endocrine neoplasia type 1 (MEN-1) are important to define who will be eligible for surgical treatment. In general, tumors bigger than 2 cm are eligible for surgical treatment, except insulinomas whose surgical resection is recommended no matter the size.