•  Normal pancreas in this panel is represented by the section of the far right.

•  The lobulated appearance is typicla.

•  The neoplasm is reddish brown in these sections and obliterates the normal architecture.

• Unknown.

• May be associated with mutation in 11q11-q13 in patients with multiple endocrine neoplasia type I (Werner^s syndrome) comprised of parathyroid hyperplasia or adenoma, pituitary adenoma and islet cell adenoma usually (occasionally carcinoma)

• Rare

• Most common in adults

• Can be seen throughout the pancreas or in the case of gastrinomas in duodenum

• Single or multiple

• Benign or malignant

• Symptoms dependent on whether the neoplasm is secreting or non-secreting

• Insulinomas lead to hypoglycemia with neurologic symptoms relieved by glucose

• Gastrinomas lead to hypersecretion of gastric acid and ulcers (Zollinger-Ellison syndrome)

• Most insulinomas (>90%) are benign; only 40% of gastrinomas are benign

• Other neoplasms include glucagonomas, somatostatinomas and VIPomas

•For more information on prognosis and treatment, consult the NCI web site.

Visit National Cancer Institute for Current Treatment

• Well demarcated, yellow to tan, firm nodules

• Cells are arranged in cords or trabeculae of cells with bland round to oval nuclei with small nucleoli and modest amounts of cytoplasm

• Resemble normal islet cells

• May see atypia and mitoses which do not indicate malignancy

• Malignancy defined by invasion or metastases

• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1169-70; 922-24.

• Current literature from PubMed at National Library of Medicine