Types of Pancreatic Tumors

Understanding pancreatic 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 grow uncontrollably to form a tumor. Most often, pancreatic cancer begins in the cells lining the ducts throughout the pancreas. 

There are two types of pancreatic tumors: exocrine tumors and endocrine tumors. Each has different risk factors and symptoms, and are treated in different ways and have different prognoses.

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 often 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 (jaundice) 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 radiographic imaging and confirmed by biopsy.

The treatment for exocrine pancreas tumors may include surgery, chemotherapy or radiation therapy, or a combination of these therapies.

Endocrine tumors (NETs)

Endocrine tumors are less common, only accounting for about 5 percent of pancreatic tumors. Often called pancreatic neuroendocrine tumors (NETs) or islet cell tumors, they are found in islet (endocrine) cells scattered throughout the pancreas. These tumors may carry a better prognosis than exocrine tumors.

Types of endocrine, or NETs, include:

  • Functional NETs. These tumors oversecrete hormones such as insulin, gastrin and glucagon. Most functioning NETs are gastrinomas or insulinomas (when tumors oversecrete insulin and affect blood sugar levels). 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 or spread to another organ before there are signs or symptoms.
  • Carcinoid tumors: These NETs are much more common in other parts of the digestive system, although they can start in the pancreas. 

Our team will perform diagnostic imaging tests such as abdominal CT scans, octreoscans or PET scans and confirm diagnosis with endoscopic or percutaneous 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.  

Pancreatic 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 some cases, these growths will not 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.
  • Intraductal papillary mucinous neoplasms (IPMNs). These benign tumors grow in the pancreatic ducts. If left untreated, they may become cancer over time. Depending on the type of IPMN or location and size, surgery may be recommended. 

Pancreatic cysts often are found during radiology imaging tests such as CT and MRI scans and are often confirmed with endoscopic imaging. 

Pancreatic 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 with findings such as:

  • A cyst larger than 3 centimeters
  • Progressive growth over time
  • Characteristics that exhibit a mixture of solid and cystic components
  • Mass effect on adjacent structures

Surgical options may include a traditional open approach, or if safe, minimally invasive options such as laparoscopic or robotic-assisted surgery.

Solid pseudopapillary neoplasms (SPNs) are another type of benign pancreatic growth. These are rare, slow-growing tumors that commonly develop in young women. Your team will work with you to determine if surgery is required or whether this tumor can be closely monitored. 

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