Diagnosis and Management of Functional Pancreatic Neuroendocrine Tumors

Functional pancreatic neuroendocrine tumors (F-pNETs) are defined as tumors located in the pancreas with hormonal overproduction associated with a specific clinical syndrome. The most common F-pNETs are insulinomas and gastrinomas, which have very distinctive syndromes of hormonal overproduction. Diagnosis of F-pNETs is based on careful evaluation of hormonal overproduction while excluding interference of medication and other external factors. Imaging studies are preferably performed after the diagnosis based on hormonal evaluation is confirmed. Treatment focuses on two principles, first decreasing hormonal overproduction and second oncological treatment, i.e., resection of the F-pNET. In most cases, the prognosis of insulinomas is excellent. Other F-pNETs have 5-year survival rates ranging from 30% to 90% depending on tumor grade and stage.