Analyses of clinical features,diagnosis,and treatment of nonfunctioning islet cell tumors

Objective To investigate the clinical features,diagnosis and treatment of nonfunctioning islet cell tumors(NFIT).Methods The clinical data of 23 patients with NFIT,who were admitted to our hospital from Jan.2002 to Dec.2008,were retrospectively studied.Results The main clinical manifestations of NFIT included abdominal mass,abdominal pain and distension and obstructive jaundice.The diagnoses of pancreatic tumors were confirmed by imaging studies including ultrasonography,CT and MRI.The average diameterof the tumors was 9.5cm.Pancreaticoduodenectomy was performed in 47.8%(11/23),resection of pancreatic body and tail together with spleen was performed in 21.7%(5/23),and other procedures were performed in 31.5%(7/23) of patients.Tumors were malignant in 13.0%(3/23) and benign in 87.0%(20/23) according to postoperative pathology.The major postoperative complication was pancreatic fistula(13.0%),and it healed by nonoperative therapies in all of the cases.One of 3 patients with malignantNFIT died within 1 year after operation,while the other 2 had survived,without tumor recurrence,for 29 months and 8 months respectively on follow-up.Seventeen patients with benign NFIT had survived for 1 to 7 years on follow-up.Conclusions The diagnosis of NFIT should be based on clinical manifestations,lab data,imaging study findings,intraoperative exploration and postoperative pathology.The prognosis of surgicaltreatment is good.