Nonfunctioning Tumors

Islet cell tumors are called "silent" or "nonfunctioning" if they are not associated with a specific clinical syndrome, such as ZES. Either these tumors do not secrete enough hormones to produce a clinical syndrome or the secreted hormone does not cause specific symptoms (e.g., pancreatic polypeptide-secreting tumor). Preoperatively, US and CT scanning are the procedures of choice and are usually effective because these tumors are relatively large, usually more than 5 cm in diameter.50 Also, SRS can be performed to differentiate endocrine from nonendocrine pancreatic tumors. We recommend that all patients with nonfunctioning tumors undergo CT or US to localize the tumor and to exclude diffuse metastases.

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