Surgical treatment of nonfunctioning islet cell tumor: report of 41 cases

BACKGROUND: Nonfunctioning islet cell tumor (NIT)as a rare pancreatic endocrine neoplasm is characterized byunspecific clinical symptoms and is hard to diagnose. InChina, NIT accounts for 15%-41% in pancreatic endocrineneoplasms just next to insulinoma. In this study, weevaluated the surgical modalities of NIT.METHODS: From January 1978 through February 2002, 41patients with NIT were treated at the Department of Sur-gery of the First Affiliated Hospital, China Medical Univer-sity, Shenyang, China. Tumors in the head of the pancreaswere noted in 28 patients, and in the body or in the tail in13 patients. The mean diameter of the tumors was 10. 7cm. Fifteen patients underwent enucleation and 21 receivedpancreatectomy. Tumors were unresectable in 5 patientsbecause of extensive infiltration. The mean diameter was9.6 cm in patients treated by enucleation, 13.1 cm in thoseby pancreaticoduodenectomy, 9.9 cm in those by distalpancreatectomy, and 11.6 cm in those with unresectabletumors.RESULTS: The curative resection rate was 88% (n =36),and the complication rate after enucleation and pancreatec-tomy was 33% ( n = 5 ) and 14% (n=3), respectively. Nolocal recurrence was found after both enucleation and pan-createctomy. Liver metastases occurred in 3 patients treatedby enucleation.CONCLUSIONS: Both enucleation and pancreatectomy areeffective for NIT of the pancreas. No local recurrence hasbeen found in patients treated by the two surgical proce-dures. The complication rates of the two modalities arecomparable.