Youtor
Functional pancreatic neuroendocrine tumors
>> YOUR LINK HERE: ___ http://youtube.com/watch?v=iJcFPWLdKLc
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...
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