Laparoscopic Surgical Treatment of Neuroendocrine Pancreatic Tumors

Pancreatic Endocrine Tumors (PNETs) represent a rare, but important subset of pancreatic neoplasms. These tumors account for 2–4% of all clinically detected pancreatic tumors. Their overall incidence is approximately 1 of 100 000 people per year [1,2]. PNETs consist of single or multiple benign or malignant neoplasms and are associated with multiple endocrine neoplasia type 1 (MEN1) in 10– 20% or Von Hippel-Lindau (VHL) syndrome. The natural history of PNETs is highly variable. Small, benign neoplasms such as 90% of all sporadic insulinomas are readily curable by surgical resection [3]. Although most gastrinomas grow slowly, 60–90% are malignant. The natural course of sporadic ZES is more aggressive than of MEN1-ZES with 15 years survival rates of 70-80 and 100%. Rare functional tumors (RFTs) such as VIPoma and glucagonoma, as well as most NF-PNETs have a less favorable prognosis [1,2]. Approximately 80% of patients already have metastases at initial presentation [1,2]. Five year survival for the group with advanced disease is 29-45% [1,3] and 60% overall.