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home - Pancreas - Pancreatic Cancers - Somatostatinoma Written by Dr Sebastian Zeki
Knowledge


Knows the presentation investigation and staging of pancreatic
cancer

Recognises the importance of considering and being able to identify
uncommon pancreatic tumours (such as neuroendocrine or
intrapapillary mucinous tuours)

Knows the range of potential therapies and recognises the factors
that make such tumours potentially operable or inoperable

Knows the prevalence and natural history of benign cysts/serous
cystadenoma and potentially malignant cystic lesions

Knows the options for palliative treatment
Skills
Shows ability to sequence investigations appropriately
Understands value of multi-disciplinary team
Recognises the importance of considering possibility that the tumour
is unusual

Behaviours
Communicates effectively within the multi-disciplinary team and with
the patient and their family

Somatostatinoma

D cells D cells Somatostatinoma Pancreatic Somato-statinoma2/3rds in head Duodenal somatostatinomausually ampullary/ periampullaryGet psamomma bodiesAssociated with Von Recklinghausen’s disease; can rarely occur elsewhereRarely associated with Somato-statinoma syndrome EpidemiologyThe incidence is the same in both sexes.The average age of diagnosis is 50.Only 10% get the syndrome.75% have metastasised by presentation. Can rarely occur elsewhere (eg colon) Somatostatinoma Syndrome Features:Diabetes mellitus (from inhibited insulin).Cholelithiasis (from inhibited CCK).Diarrhoea with steatorrhea ( from inhibited pancreatic enzyme and bicarb secretion). DiagnosisThe somatostatin level >160 pg/mL.US/CT/MRI ca visulaise the lesion. Prognosis5-year survival rates are 15 %.Outcomes are better in patients with duodenal somatostatinomas. D cells Written by Dr Sebastian Zeki

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