Types of Pancreas Tumors

Understanding pancreas tumors and cysts.

The pancreas is a long, flat organ located deep in the abdomen. It is serves two major functions: hormone production and digestion. In addition to secreting enzymes that help the body absorb nutrients during digestion, it also helps regulate blood sugar with hormones such as insulin.

Pancreatic cancer occurs when mutations in your DNA cause cells to grown uncontrollably. These cells can form a tumor. Most often pancreatic cancer begins in the cells of the small sacs that line the ducts throughout the pancreas. 

The two main types of pancreatic cancer are called exocrine and endocrine. Each has different risk factors, symptoms, and are treated in different ways and have different outlooks.

Exocrine tumors

Exocrine (pronounced X-so-crin) tumors account for 95 percent of all pancreatic cancer diagnoses.  Exocrine tumors of the pancreas include:

  • Pancreatic adenocarcinoma. These cancers usually start in the ducts of the pancreas, but Less can develop from the cells that make the pancreatic enzymes (acinar cell carcinomas).
  • Ampullary cancer (carcinoma of the ampulla of Vater). This cancer occurs where the bile duct and pancreatic duct come together and empty into the small intestine (called the ampulla of Vater). It is often diagnosed at an earlier stage because it causes noticeable yellowing of the skin and eyes (Jaunice) due to a blockage in the bile duct.  
  • Less common types of exocrine tumors. These tumors account for 1 percent to 4 percent of all exocrine tumors: Adenosquamous carcinomas, squamous cell carcinomas, signet ring cell carcinomas, undifferentiated carcinomas, and undifferentiated carcinomas with giant cells 

Pancreatic exocrine tumors are diagnosed using a diagnostic laparoscopy. This procedure provides high resolution imaging, allowing physicians to see the tumor and cancer cells with greater precision.

Treatment may include surgery, chemotherapy or radiation therapy, or a combination of these therapies.

Endocrine tumors (NETs)

Endocrine tumors are less common, accounting for about 5 percent of pancreatic tumors. Often called pancreatic neuroendocrine tumors (NETs) or islet cell tumors, they are found in islet cells (endocrine) scattered throughout the pancreas. These tumors may carry a better prognosis than exocrine tumors. Some may not need surgery and may not be cancerous.

Types of endocrine, or NETs, include:

  • Functional NETs. These tumors make too much of a hormone such as insulin, gastrin and glucagon. Most functioning NETs are gastrinomas (when tumors form in cells that make the hormone gastrin to cause the stomach to release an acid that helps digest food) or insulinomas (when tumors form in cells that make the hormone gastrin to cause the stomach to release an acid that helps digest food. Functional NETs also include glucagonoma, which is caused by tumors that form in cells that make glucagon, a hormone that increases glucose in the blood. 
  •  Non-functional NETs. These tumors do not make enough excess hormones to cause symptoms. They may grow for a long time without causing signs or symptoms or spreading to another organ before there are signs.
  • Carcinoid tumors: These NETs are much more common in other parts of the digestive system, although rarely they can start in the pancreas. 

Our team will perform diagnostic tests such as abdominal CT scan, endoscopic ultrasound and laparotomy (a surgical procedure to obtain a biopsy).  

These tests will help to determine the specific tumor type and stage of the tumor, so that our team can create a personalized treatment plan for you.  

Most often, chemotherapy is the first line of treatment for NETs. Chemotherapy is typically followed by surgery to remove some NETs, especially if the cancer has not spread to other areas of the body.

Other surgeries remove different parts of the pancreas and other organs, including the Whipple procedure. 

Pancreas cysts and benign growths

Some growths in the pancreas are benign (not cancer) or may be considered “precancerous” (if left untreated, they will become cancerous over time). In most cases these growths will require treatment.

Cysts are one type of benign and precancerous growth in the pancreas. Pancreatic cysts are saclike pockets growing in your pancreas. 

There are many types of cysts, each with different symptoms and treatments. The most common types of cysts are: 

  • Serous cystic neoplasms (SCNs, or serous cystadenomas). These are tumors that have sacs (cysts) filled with watery fluid. SCNs are almost always benign, and most only require treatment if they are large or cause symptoms.
  • Mucinous cystic neoplasms (MCNs, or mucinous cystadenomas). These are slow-growing -precancerous tumors that have cysts filled with a jelly-like substance called mucin. MCNs most often occur in women. If left untreated, MCNs may become cancerous. 

Pancreas cysts often are found during radiology imaging tests such as endoscopic ultrasound, CT or MRI scans for another problem. 

Pancreas cysts can be associated with certain underlying hereditary disorders such as von Hippel- Lindau disease and are seen in about 10 percent of patients with polycystic kidney disease. 

CT, MRI and other tests better identify which cysts may need surgery. These include cases where a cyst is larger than 3 centimeters or growing; has a solid component; is causing pressure on nearby structures such as the bile duct or if the main pancreatic duct is widened. 

Surgery may be minimally invasive laparoscopy, traditional open surgery or robotic-assisted surgery. 

Other benign pancreas growths include: 

  • Intraductal papillary mucinous neoplasms (IPMNs). These benign tumors grow in the pancreatic ducts. If left untreated, they may become cancer over time. Treatment typically includes active observation. In certain cases, IPMNs may require surgery if they are in the main pancreatic duct.
  • Solid pseudopapillary neoplasms (SPNs). A rare, slow-growing tumor that commonly develop in young women. Because these tumors may spread to other parts of the body, your physician may recommend surgery to remove them.
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