Belotto Marcos, Crouzillard Bruna do Nascimento Santos, Araujo Karla de Oliveira, Peixoto Renata D'Alpino
Depa, German Hospital Oswaldo Cruz.
Faculty of Medical Sciences, Santa Casa de São Paulo.
Arq Bras Cir Dig. 2019 Feb 7;32(1):e1428. doi: 10.1590/0102-672020180001e1428.
Pancreatic neuroendocrine tumors (pNET) correspond to about 3% of all tumors in pancreas and could be presented as a difficult diagnosis and management.
To review the diagnosis and treatment of the pNET available in scientific literature.
A bibliographic survey was performed by means of an online survey of MeSH terms in the Pubmed database. A total of 104 articles were published in the last 15 years, of which 23 were selected as the basis for the writing of this article.
pNET is an infrequent neoplasia and their incidence, in USA, is about 1:100.000 inhabitants/year. Thereabout 30% of them produce hormones presenting as a symptomatic disease and others 70% of the cases could be silent disease. Magnetic Resonance Imaging (MRI) and/or Computed Tomography (CT) have similar sensitivy to detect pNET. They are very important when associated to nuclear medicine mainly Positron Emission Tomography (PET-CT) Gallium-68 to find primary tumor and its staging. The appropriate treatment should be chosen based on characteristics of the tumor, its staging and associated comorbidities.
The surgical resection is still the best treatment for patients with ressectable pancreatic NETs. However, the size, grade, tumor functionality, stage and association with multiple endocrine neoplasia type 1 (MEN-1) are important to define who will be eligible for surgical treatment. In general, tumors bigger than 2 cm are eligible for surgical treatment, except insulinomas whose surgical resection is recommended no matter the size.
胰腺神经内分泌肿瘤（pNET）约占胰腺所有肿瘤的3%，诊断和治疗可能具有挑战性。
回顾科学文献中关于pNET的诊断和治疗。
通过在PubMed数据库中对医学主题词进行在线检索进行文献调查。过去15年共发表了104篇文章，其中23篇被选为本篇文章的撰写依据。
pNET是一种罕见的肿瘤，在美国，其发病率约为每年1:100000居民。其中约30%会产生激素，表现为有症状的疾病，另外70%的病例可能为无症状疾病。磁共振成像（MRI）和/或计算机断层扫描（CT）检测pNET的敏感性相似。当与核医学主要是正电子发射断层扫描（PET-CT）镓-68联合用于发现原发肿瘤及其分期时，它们非常重要。应根据肿瘤的特征、分期和相关合并症选择合适的治疗方法。
手术切除仍然是可切除的胰腺NET患者的最佳治疗方法。然而，肿瘤的大小、分级、功能、分期以及与1型多发性内分泌肿瘤（MEN-1）的关联对于确定哪些患者适合手术治疗很重要。一般来说，直径大于2cm的肿瘤适合手术治疗，但胰岛素瘤无论大小均建议手术切除。
