Surgical management of pancreatic neuroendocrine neoplasms

Abstract

Tumors originating in the islet cells are also known as pancreatic neuroendocrine neoplasms (pNENs), and tumors are classified into well-differentiated NET and poorly-differentiated NEC. Functional tumors produce excess hormones that can lead to clinical syndromes, but the majority of pNENs are not associated with elevated hormone levels nor cause clinical syndromes, and are termed "non-functional". New drugs and treatments such as PRRT have been approved for pNENs in recent years, and options are expanding. However, pNENs have high malignant potential, and when possible radical resection is indicated as for other gastrointestinal cancers. Regarding treatment strategy for small, non-functioning pNETs that are diagnosed incidentally, some guidelines conditionally recommend observation, but caution is advised.