Pancreatic Neuroendocrine Tumors: Spectrum of Clinical Presentation from a Tertiary Referral Center in Pakistan

Background: Pancreatic neuroendocrine tumors (P-NETs) constitute a subset of pancreatic mass lesions characterized by diverse clinical presentations. Despite their inherent malignant potential, the timely identification and treatment of these tumors are critical for achieving favorable clinical outcomes. This study aims to shed light on the heterogeneous tumor biology of P-NETs and the management strategies employed at a tertiary care center in Pakistan.Method: A retrospective study encompassing all patients with a biopsy-confirmed diagnosis of P-NETs at Shifa International Hospital between January ۱st, ۲۰۱۶, and June ۳۰th, ۲۰۲۱, was conducted. Meticulous data extraction from pathology records and thorough searches of medical records were performed to gather relevant demographic and clinical information.Results: A total of ۲۴ patients were retrieved from our database, with ۱۳ (۵۴%) female patients. The mean age was ۴۹.۵ ± ۱۶.۳ years. Eight out of the ۲۴ patients presented with abdominal pain. Most patients (۱۴ out of ۲۴) had lesions in the pancreatic head region. In three cases, lesions exhibited multicentricity. The mean lesion size measured ۴.۴ ± ۲.۳ cm. Three of the ۲۴ patients displayed distant liver metastasis at the presentation time. ۱۹ out of the ۲۴ patients underwent surgical resections, while endoscopic ultrasound (EUS)-guided biopsy was performed in ۴ out of ۲۴ cases. EUS-guided tissue biopsy yielded accurate diagnoses in all four cases.Conclusion: Most P-NETs are non-functional, and there is an almost equal distribution between male and female patients. Solitary lesions predominate, and metastasis is uncommon at initial presentation. EUS-guided fine needle biopsy stands out as a dependable diagnostic modality for P-NETs.