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World J Gastroenterol. 2015 Aug 28;21(32):9512-25. doi: 10.3748/wjg.v21.i32.9512.

Non-functional neuroendocrine tumors of the pancreas: Advances in diagnosis and management.

Author information

1
Jordan M Cloyd, George A Poultsides, Department of Surgery, Stanford University, Stanford, CA 94305, United States.

Abstract

Nonfunctional neuroendocrine tumors of the pancreas (NF-PNETs) are a heterogeneous group of neoplasms. Although rare, the incidence of NF-PNETs is increasing significantly. The classification of PNETs has evolved over the past decades and is now based on a proliferation grading system. While most NF-PNETs are slow growing, tumors with more aggressive biology may become incurable once they progress to unresectable metastatic disease. Tumors of higher grade can be suspected preoperatively based on the presence of calcifications, hypoenhancement on arterial phase computed tomography, positron emission technology avidity and lack of octreotide scan uptake. Surgery is the only curative treatment and is recommended for most patients for whom complete resection is possible. Liver-directed therapies (thermal ablation, transarterial embolization) can be useful in controlling unresectable hepatic metastatic disease. In the presence of unresectable progressive disease, somatostatin analogues, everolimus and sunitinib can prolong progression-free survival. This article provides a comprehensive review of NF-PNETs with special emphasis on recent advances in diagnosis and management.

KEYWORDS:

Islet cell; Neuroendocrine carcinoma; Neuroendocrine tumor; Octreotide; Pancreas

PMID:
26327759
PMCID:
PMC4548112
DOI:
10.3748/wjg.v21.i32.9512
[Indexed for MEDLINE]
Free PMC Article

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