Background: Diagnosis of small pancreatic neuroendocrine incidentalomas (PNETs-I) is increasing during last years and often their management remains unclear.
Objective: To describe our experience with patients with PNETs-I in our institution.
Methods: Since March 2000, patients with non functioning PNETs-I ≤30 mm were evaluated in our center, prospectively. A descriptive analysis of all patients and a comparative study between observational group (OG) vs resection group (RG) was made.
Results: Forty-six patients were evaluated: 36 in OG and 10 in RG. Median follow up (months) was 35.9 in OG and 76.6 in RG. Most of patients (69.9%) were diagnosed in the last 6 years. Mean age (years): 69.5 in OG and 57 in RG (P<0.003). Gender: 56.5% women. Mean tumor size (mm) was 12.5 (11 in OG vs 18.7in RG P<0.005). PNETs-I were multiple in 17.4% cases. At diagnosis, all PNETs-Is size were≤20 mm in OG, without metastases. In RG, 8 patients (80%) had surgery complications, mostly mild to moderate without deaths. Diagnosis was made by imaging procedures in 91.6% of OG. In our series, 82% had a CgA assessment at diagnosis. Median CgA value was 179 μg/l (72304). At the end of follow up, 88% in OG of patients had no change in tumor size, the rest had tumor growth <20%; In OG no PNETs-I resection were needed, and none of the patients metastasized or died because of PNETs-I in this group.
Conclusions: Non functioning PNETs-I is increasing in incidence in our center. After almost 36 months of follow up, no patients had significant growth, developed metastases and neither of them died from PNETs-I. In OG, active surveillance is safe in selected PNETs-I patients. We need prospective multicentric studies to confirm our results.
20 - 23 May 2017
European Society of Endocrinology