Pancreatic neuroendocrine tumor types and symptoms
Sometimes symptoms of a pancreatic NET occur because the tumor has grown large or turned malignant (cancerous) and spread. These symptoms can overlap with other conditions, including more common forms of pancreatic cancer.
Signs and symptoms include:
- Back or belly pain
- Bone pain
- Diarrhea
- Indigestion
- Jaundice (yellowing of skin or eyes)
- Loss of appetite
- Lump in the belly
- Shortness of breath or coughing
- Unintended weight loss
About half of pancreatic NETs release hormones that upset the body’s normal balance. This hormonal disruption may cause noticeable symptoms to show up while a tumor is still small.
The particular symptoms experienced depend on the form of tumor, named after the principal hormone released:
Gastrinomas are one of the more common hormone-releasing NETs in the pancreas and may also occur in the duodenum (small intestine’s first section). Sometimes there are multiple tumors. Gastrinomas release gastrin, which boosts stomach acid. Symptoms cause Zollinger-Ellison syndrome (ZES) and include:
- Diarrhea
- Peptic ulcers (painful sores on the lining of the stomach or small intestine)
- Steatorrhea (oily stools)
Insulinomas are another common, hormone-releasing pancreatic NET. Diagnosis requires staying in the hospital for several days for testing. The tumors release extra insulin, which leads to:
- Hypoglycemia (low blood sugar, which can cause neuroglycopenia, or brain function interference)
- Obesity
These tumors release glucagon, a hormone that increases blood sugar. Symptoms include:
- Anemia (low red blood cell count)
- Blood clots
- Diabetes
- Glossitis (swollen and inflamed tongue)
- Necrolytic migratory erythema (particular rash around the genitals, anus, buttocks, groin and lower legs)
- Unintended weight loss
These tumors release the hormone vasoactive intestinal peptide (VIP), causing:
- Achlorhydria (lack of hydrochloric acid in stomach juices)
- Flushing (warmth and redness in the face)
- Hypercalcemia (too much calcium in the blood)
- Hyperglycemia (high blood sugar)
- Hypokalemia (low potassium)
- Metabolic acidosis (too much acid in the body)
- Watery diarrhea
These rare tumors release somatostatin, leading to:
- Diabetes
- Diarrhea
- Gallstones
- Hyperglycemia (high blood sugar)
- Hypochlorhydria (low stomach acid)
- Steatorrhea (oily stools)
- Unintended weight loss
These rare tumors release pancreatic polypeptide, sometimes causing:
- Belly pain
- Hepatomegaly (enlarged liver)
- Watery diarrhea