Pancreatic Tumors From the Islets of Langerhans

Pancreatic tumors derived from the islets of Langerhans are a diverse group of tumors that may have different clinical characteristics and secretory activities. In this article we will consider the main aspects of pancreatic tumors from the islets of Langerhans, their diagnosis and treatment.

Pancreatic tumors from the islets of Langerhans are most often adenomas, which account for up to 90% of all pancreatic tumors. It is important to note that the characterization of a tumor as malignant is not based on data from a morphological study, since tumor growths are usually highly differentiated, but on the fact of the occurrence of metastases. Metastases from pancreatic tumors from the islets of Langerhans are most often localized in the liver, sometimes in the lungs, bones and brain.

Approximately 20% of tumors from the islets of Langerhans are characterized by endocrine secretion, which significantly affects the clinical picture of the disease. The size of tumors is usually less than 2 cm, and the level of endocrine secretion does not depend on the size of the tumor. This means that secreting adenomas can be detected at an early stage. Tumors from the islets of Langerhans have different clinical characteristics depending on the cellular source of the tumor, such as α cells or P cells, and other elements of the islets of Langerhans.

The α-cell tumor releases glucagon and can lead to hyperglycemia and dermatitis. P-cell tumors, also known as insulinomas, secrete insulin and can cause severe hypoglycemic crises. In some cases, gastritis and Zollinger-Ellison syndrome may develop, characterized by severe gastric hypersecretion, ulcers of the stomach, duodenum and jejunum.

Tumors that secrete serotonin (carcinoid) can lead to the development of carcinoid syndrome. Tumors that secrete adrenocorticotropic hormone (ACTH) can cause Cushing's syndrome. The clinical course of tumors from the islets of Langerhans is usually slow.

Treatment of pancreatic tumors from the islets of Langerhans usually requires surgery, such as pancreatectomy. However, in the presence of metastases, surgery may be ineffective. In such cases, antitumor drugs are used, which can have a symptomatic effect. For example, 5-fluorouracil is administered intravenously at a dose of 500 mg and streptozotocin is administered intravenously at a dose of 1000 mg, for 1-5 days.

In conclusion, pancreatic tumors of the islets of Langerhans are a diverse group of tumors that may have different clinical characteristics depending on the secretion activity and cellular source of the tumor. Diagnosis and treatment of such tumors require a comprehensive approach, including clinical studies, educational programs and surgical techniques. Early detection and treatment of tumors from the islets of Langerhans are important to improve the prognosis and quality of life of patients.