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This is a brief video on pancreatic neuroendocrine tumors that are functional and secreting excess hormones that have systemic effects. I created this presentation with Google Slides. Image were created or taken from Wikimedia Commons I created this video with the YouTube Video Editor. ADDITIONAL TAGS: Functional pancreatic neuroendocrine tumors “Islet cell tumors†Neoplasms that arise from the endocrine pancreas that actively secrete hormones to have systemic effects Gastrinoma Insulinoma Glucagonoma VIPoma Somatostatinoma Salt and pepper chromatin -- indicative of neuroendocrine differentiation By Nephron - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index... Gastrinoma Second most common PNET Gastrin secreting tumor of the endocrine pancreas (can also occur in the duodenum Gastrin induces gastric acid secretion Gastrin normally comes from G cells that are NOT found in endocrine pancreas Causes recurrent ulcers in the stomach, duodenum, and jejunum (don’t usually get ulcers that far down) Ulcers don't respond to conventional therapy Presents with abd pain, diarrhea Diagnose with failed suppression by secretin, which normally inhibits gastrin release; high blood gastrin levels Treat with somatostatin (octreotide) or surgical resection Causes Zollinger-Ellison syndrome Gastrinoma Insulinoma Glucagonoma VIPoma Somatostatinoma Insulinoma Most common PNET Insulin secreting tumor of the endocrine pancreas (beta cells) Presents with hypoglycemia symptoms (hungry, nervous, sweating; progresses to lethargy, confusion, coma) Whipple’s triad: hypoglycemia (sugar below 55), symptoms of hypoglycemia, symptoms corrected with administration of glucose Bloodwork shows: Low glucose High insulin High C-peptide Unlike exogenous use Pathology: usually small, Treat with surgical resection CC BY-SA 3.0, https://commons.wikimedia.org/w/index... Gastrinoma Insulinoma Glucagonoma VIPoma Somatostatinoma Glucagonoma Rare tumor; often malignant Glucagon secreting tumor of the endocrine pancreas (alpha cells) Bloodwork shows increased glucagon, often increased glucose Presents with mild diabetes, dermatitis called necrolytic migratory erythema, decreased weight, decreased RBCs (anemia), venous thrombosis (DVT), Treat with somatostatin (octreotide) or surgical resection Gastrinoma Insulinoma Glucagonoma VIPoma Somatostatinoma VIPoma AKA Verner-Morrison syndrome Rare tumor, most are malignant VIP secreting tumor of the endocrine pancreas (D1 cells) Vasoactive intestinal peptide (VIP) Normal role in gut is to stimulate secretion of water and electrolytes Presents as profuse and explosive and watery diarrhea Results in low HCl (hypochlorhydria), low K, and dehydration Gastrinoma Insulinoma Glucagonoma VIPoma Somatostatinoma Somatostatinoma Rare tumor, most are malignant Somatostatin secreting tumor of the endocrine pancreas (D or delta cells) Somatostatin inhibits: Gastrin, Cholecystokinin (CCK), Secretin, Motilin, Vasoactive intestinal peptide (VIP), Gastric inhibitory polypeptide (GIP), Enteroglucagon Presents with mild diabetes, gallstones, steatorrhea, hypochlorhydria Treat with somatostatin (octreotide) or surgical resection Less common PNETs: ACTHoma, CRHoma, calcitoninoma, GHRHoma, GRFoma, and parathyroid hormone–related peptide tumor Gastrinoma Insulinoma Glucagonoma VIPoma Somatostatinoma Multiple endocrine neoplasia Gastrinoma Insulinoma Glucagonoma VIPoma Somatostatinoma By Mikael Häggström - Own work, CC0, https://commons.wikimedia.org/w/index...