To diagnose a pancreatic neuroendocrine tumor (a type of cancer that forms tumors in the pancreas) your doctor will first evaluate your medical history and ask you questions about your lifestyle habits and symptoms. They will perform a physical examination and look for signs such as any swelling in the abdomen.
To confirm the diagnosis, your doctor may order the following tests and procedures.
8 diagnostic tests for pancreatic neuroendocrine tumors
Computed tomography (CT) scan
A CT scan will take multiple X-rays from different angles to provide detailed images of the inside of the abdomen, including the pancreas. This test will let the doctor know if the pancreatic neuroendocrine tumor has spread to nearby lymph nodes or other organs such as the liver. Additionally, it can be used to guide a biopsy needle into the suspicious tissue for examination under a microscope.
Magnetic resonance imaging (MRI)
MRI scans provide detailed images of organs in the body by using radio waves and strong magnets instead of X-rays. A special substance known as contrast dye may be injected into your vein before the scan to get better details.
Ultrasound
- Abdominal ultrasound: Uses a probe that is moved over the skin of the abdomen and uses sound waves to provide detailed images of the organs, including the pancreas.
- Endoscopic ultrasound: Uses a thin tube fitted with an ultrasound probe that is inserted through your mouth or nose so that it gets very close to the pancreas. If an abnormal growth is observed, a biopsy needle can be passed down the endoscope to get samples of the abnormal tissue for biopsy.
Cholangiopancreatography
It is an imaging test that looks for blockage, narrowing, or dilatation of the bile ducts and pancreatic ducts, which have been caused by a pancreatic neuroendocrine tumor. It can be done in different ways including:
- Endoscopic retrograde cholangiopancreatography
- Magnetic resonance cholangiopancreatography
Radionuclide scans
Radionuclide scan uses a small amount of radioactivity and special cameras to help find tumors or look for areas of cancer spread. This is usually done if doctors cannot identify the location of the tumor in the body.
Positron emission tomography (PET) scan
PET scans involve detecting poorly differentiated pancreatic neuroendocrine carcinomas with the use of radioactive substances.
Somatostatin receptor scintigraphy (Octreoscan)
A small amount of octreotide (a hormone-like substance that attaches to the pancreatic neuroendocrine tumor cells) joined to a radioactive substance is injected into a vein. The substance travels through the blood where it attaches to the pancreatic neuroendocrine tumor. It highlights the tumor areas that can be detected with the help of a special camera.
Blood and urine tests
Blood tests that measure the levels of the following hormones are performed to diagnose pancreatic endocrine tumors:
- Insulin
- Gastrin
- Glucagon
- Somatostatin
- Pancreatic polypeptide
- Vasoactive intestinal peptide
Other tests will look for the levels of:
- Chromogranin A
- Glucose
- C-peptide (for insulinomas)
- Serotonin
- 5-HIAA
- 5-HTP
- Neuron-specific enolase
- Substance P
Depending on the location of the tumor and your symptoms, doctors might order other blood tests.
Neoplasms of the Endocrine Pancreas Workup. https://emedicine.medscape.com/article/276943-workup#c3
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