Non-functioning Pancreatic Neuroendocrine Tumors (PNET): Association with Prediabetes/Diabetes

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 327-337-Neuroendocrine Tumors
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-330
Etty Osher*1, Erez Scapa2, Yona Greenman3, Karen Michele Tordjman3, Yael Sofer3, Alaa Melhem2, Mendy Ben haim2, Ido Nachmany2, Ravit Geva2, Erwin Santo2 and Naftali Stern3
1Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, 2Tel Aviv-Sourasky Medical Center, 3Tel Aviv Sourasky Med Ctr, Tel Aviv, Israel
Background Neuroendocrine tumors of pancreas (PNET) are classified as functional or nonfunctional (NF) based on presence or absence of a clinical syndrome associated with hormone over secretion. NF-PNETs do however often produce low levels of- or inactive hormones (pancreatic polypeptide, calcitonin or neurotensin) which do not cause any symptoms. 

Goals This retrospective study was performed to evaluate if there is a metabolic impairment in NF-PNET.

Results: Thirty nine consecutive patients with histologically confirmed NF-NETs were assessed, with a F/M ratio 14/25, mean (+/-SD) age of 60.7±12.8 y, 22 with previous pancreatic surgery and 17 prior to/without surgery. Mean tumor size was 2.8±2.3 cm. More than two thirds (66%) of this cohort had impaired glucose metabolism:  44% (17/39) had overt diabetes mellitus (DM) and 23% had impaired fasting glucose (IFG). Mean (on treatment, in several patients) fasting glucose level was 111±21mg/dl, HBA1c 6.9±2.1% and BMI 28.7± 6.3 kg/m2. The rate of DM in subjects operated for PNET and subjects who were not operated on was 45% and 35%, respectively and the corresponding rates for IFG was 24% and 23%, respectively.  BMI was lower in the subgroup subjected to surgery   (26.1±2.4 vs. 32 ±8 kg/m2; p<0.02).

Conclusion: This is the first report presenting the surprising finding of a   high prevalence of impairment in glucose metabolism in patients with NF-PNET. The high prevalence of diabetes/prediabetes cannot be attributed to age, obesity or surgery alone, though each could have a contributory role.   If verified in larger series of patients, this observation should prompt re-examination of the term "non-functioning" in the context of PNET and/or raise the possibility of increased rate of "NF"-PNETs in type 2 diabetes/prediabetes.

Nothing to Disclose: EO, ES, YG, KMT, YS, AM, MB, IN, RG, ES, NS

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