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Islet Cell Carcinoma in Mesenteric Fat
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Islet Cell Carcinoma in Mesenteric Fat

Cut surface of an islet cell carcinoma of the pancreas.
There is no diagnostic gross feature to this tumor
Note the firm looking, yellow-tan tissue at the black arrow.
The arrow points to the location of the tumor
(Description By:Melinda Sanders, M.D. )
(Image Contrib. by: Saint Francis Hospital )
Islet Cell Neoplasms
Etiology

Unknown.
Pathogenesis

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),
Epidemiology

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
General Gross Description

Well demarcated, yellow to tan, firm nodules
General Microscopic Description

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
Clinical Correlation

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
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1169-70; 922-24.
Islet Cell Neoplasms
Synopsis by: Melinda Sanders M.D. (T59000M81503)[408]
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