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Patient with hypercalcemia and islet cell
carcinoma of the pancreas (parathyrinoma).An
Med Interna. 2001 Jun;18(6):339-40
Pancreatic islet cell
tumors.Surgery. 1986
Jun;99(6):671-8.
Tumors arising
from the pancreatic islet cells represent a heterogeneous group of
lesions. Some tumors present with well-characterized syndromes, while
others appear to be nonfunctioning. Eighty-four patients with
pancreatic islet cell tumors operated on at the Cleveland Clinic
during a 35-year period were reviewed. The tumor types include 21
nonfunctioning tumors, 41 insulinomas, 16 gastrinomas, two vasoactive
intestinal polypeptide (VIP)-omas, two carcinoids, and two probable
cases of pancreatic parathyrinoma. Eleven patients had multiple
endocrine neoplasia type I syndrome. Preoperative localization was
possible in 63% of patients in whom it was attempted. Complete
mobilization of the head and distal pancreas with bimanual palpation
of the entire gland is critical for intraoperative tumor localization.
Distal pancreatectomy is favored for tumors in the body and tail. In
the head of the pancreas, small, benign lesions require enucleation,
and large or malignant lesions necessitate a Whipple procedure. The
operative morbidity rate was 24%, and the mortality rate was 3.6%. The
10-year survival rate was 54.7% for nonfunctioning lesions, 68.4% for
gastrinomas, and 92.4% for insulinomas. At this time surgery
represents the only way to cure these lesions.
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