PANCREATITIS ASSOCIATED WITH NEUROENDOCRINE (ISLET-CELL) TUMORS OF THE PANCREAS

BACKGROUND: The association of pancreatitis with neuroendocrine tumors of the pancreas is uncommon, whereas its association with exocrine pa ncreatic cancer is well recognized. Since the latter, but not the isle t cell tumor, is thought to originate within the ductal system, it is not surprising that pancreatitis is less likely to result from the isl et cell tumor, The senior author has recently noted that the first rec ognizable indication of an islet cell carcinoma may be one or more dis crete attacks of acute pancreatitis, METHODS AND RESULTS: Acute pancre atitis, resulting from an islet cell tumor, has been observed in five patients, in one of whom it had become chronic. In four of the patient s, the tumor was malignant, A review of the English language literatur e reveals 14 such patients with pancreatitis, and 2 others have been n oted in other languages (a total of 21 patients), The tumor was malign ant in 15 of the 21 patients (71%), Although the development of pancre atitis was found to result from the obstruction of the duct in most pa tients, at least three seemed unrelated, In 12 of 21 cases (57%), an a cute attack of pancreatitis, usually recurrent, was the initial syndro me, in contradistinction to pancreatitis resulting from exocrine tumor s, which has usually been chronic in nature, CONCLUSION: Pancreatitis, particularly acute pancreatitis, may result from an islet cell tumor, Although unusual, its occurrence may be the first signal of the prese nce of the tumor, In our experience, obstruction of the pancreatic duc t by the islet cell carcinoma appears to be the important etiologic fa ctor.