Endocrine Tumors of the Abdomen
What is an endocrine gland?
An endocrine gland is a specialized structures that are found in different parts of the body that secrete hormones.
What is a hormone?
Hormones are chemical substances that are delivered directly into the blood from endocrine organs. Hormones can produce profound effects on many parts of the body. For example insulin is a hormone that controls blood sugar levels. Testosterone is a hormone that causes the development of male sexual characteristics.
What are endocrine tumors
Endocrine tumors are abnormal growths in endocrine glands. Since endocrine glands produce hormones, tumors of endocrine glands also produce hormones. These hormones are produced in excessive amounts by endocrine tumors and then released into the blood.
The excessive amounts of hormones in the blood produce markedly abnormal effects on the body. For example in normal individuals insulin is secreted from pancreatic islet cells in just the right amount to keep your blood sugar levels within normal limits. In patients with insulin producing islet cell tumors of the pancreas, excessive insulin is produced in the blood that cause large decreases in blood sugar levels so that patients suffer from severe effects of low blood sugar.
Are endocrine tumors benign (non-cancerous) or malignant (cancerous)?
Endocrine tumors can be benign or grow as cancers. Often this distinction between cancer and not cancer is very difficult even after removal of the tumors. In some patients removal of what was thought to be a benign growth may come back as a cancerous recurrence. All patients with endocrine tumors of the abdomen should be followed carefully to detect early recurrence of the cancer.
What are abdominal endocrine tumors?
There are many endocrine glands that found in the abdomen. The two most important are:
Tumors can arise from both these two endocrine glands. Up to half of all tumors produce excess amounts of hormones that produce symptoms in the affected patient.
What are adrenal tumors
The adrenal gland is really two organs in one. The outer part of the adrenal is called the cortex and the inner part of the adrenal medulla. The two parts of the adrenal perform different functions and have different embryological origins.
Tumors of the adrenal glands arise from the cortex or the medulla part of the adrenal gland. Adrenal tumors commonly present because of excess secretion of hormones by the tumor. The tumors that commonly occur in the adrenal gland are:
Adrenal tumors can be benign (non-cancerous) or malignant (cancer). Often this separation is difficult to make and long term close follow up is necessary after removal to detect recurrences early in patients who have adrenal cancer.
What is the treatment for adrenal tumors?
Adrenal tumors should be removed by surgery. Some of the procedures offered at USC for adrenal tumors are:
What are islet cell tumors of the pancreas?
Islet cell tumors of the pancreas are rare tumors. These tumors are often also called pancreatic neuroendocrine tumors.
Islet cell tumors of the pancreas are different from adenocarcinoma of the pancreas. These tumors tend to be slow growing tumors that are treatable even after they have metastasized. Islet cell tumors can produce dramatic symptoms since up to half of these tumors may secrete hormones that produce side effects due to excessive secretion of the hormones.
What are the different types of islet cell tumors?
The following types of neuroendocrine tumors are recognized:
- Non-functioning islet cell tumors: Patients with non-functioning tumors do not have any symptoms from excess secretion of pancreatic hormones since the tumor does not secrete any hormones into the blood.
- Functional islet cell tumors: These tumors produce dramatic symptoms because of excess secretion of various different hormones from the tumor in the pancreas.
The following types of functional islet cell tumors are recognized:
- Insulinoma: a tumor that produces excessive amounts of insulin.
- Gastrinoma: a tumor that produces excessive amounts of gastrin
- Glucagonoma: an extremely rare tumor that produces excessive amounts of Glucagon.
- VIPoma: an extremely rare neuroendocrine tumor the produces excessive amounts of VIP.
- Somatostatinoma: an extremely rare tumor that produces excessive amounts of somatostatin.
Treatment for non-functioning islet cell tumors
Surgical removal of non-functioning islet cell tumors is often curative. These tumors typically tend to be large and therefore enucleation of the tumor is usually not possible.
Our approach is to remove these tumors preferentially laparoscopically. An open procedure is usually offered to the patient if there is metastases, for very large tumors (greater than 10 centimeters), if there is invasion of the major blood vessels around the pancreas by the tumor, and by patient preference. For all other patients, the laparoscopic procedure is offered as the treatment of choice.
We offer the following laparoscopic procedures for removal of non-functioning islet cell tumors of the pancreas:
Functioning islet cell tumors
Functional islet cell tumors often present in a dramatic fashion due to secretion of excessive amounts of hormones such as insulin, gastrin, or glucagon. These tumors tend to present at a very early stage when the tumor is tiny and is often not readily detectable.
Localization of these tumors in the pancreas is an important consideration since the tumors may be very small, only a few millimeters in size, when the patient presents with major symptoms.
Treatment of functioning islet cell tumors
The different types of functioning islet cell tumors require special consideration for surgery. Surgery is tailored to the type of the tumor. For further details click on the following links: