Tasneem AA, Luck NH, Mubarak M. Pancreato-hepatobiliary neuroendocrine tumors diagnosed through endoscopic ultrasound: Clinical characteristics and factors associated with high-grade lesions.
World J Gastrointest Endosc 2025;
17:105904. [DOI:
10.4253/wjge.v17.i6.105904]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2025] [Revised: 03/21/2025] [Accepted: 04/07/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND
Neuroendocrine tumors (NETs) are an important type of neoplastic disease of the digestive tract. There is little data on NETs originating from the pancreato-hepatobiliary region of the digestive tract in Pakistan.
AIM
To evaluate different types of pancreato-hepatobiliary NETs (PHB-NET) diagnosed with endoscopic ultrasound (EUS) and to identify factors associated with high-grade NETs.
METHODS
All patients diagnosed with PHB-NET through EUS-guided biopsy were included in the study. The site of origin, histology, and grade of PHB-NETs were noted and factors associated with high-grade lesions were analyzed. SPSS, version 20.0 was used for statistical analysis.
RESULTS
A total of 36 patients with PHB-NET were included. Males and females were equal in numbers, i.e., 18 (50%) each. The mean age was 48 ± 15.7 years with an age range of 17-70 years. The most common sites of origin of PHB-NET were: Pancreas 20 (55.6%), porta hepatis mass 8 (22.2%), perigastric mass 3 (8.3%) and others 5 (13.9%). The mean size of the PHB-NETs was 34.7 ± 22.5 mm. Among pancreatic NETs, the most commonly affected areas were body 9, tail 5, and head 5. Only 4 (11.1%) PHB-NETs were functioning, all of which were insulinomas originating from the body or tail of the pancreas. Two-thirds of PHB-NETs, 24 (66.6%), were benign (WHO grade I: 19; grade 2: 5) while one-third 12 (33.3%) were neuroendocrine cancers (NEC) (WHO grade III). Histological types were large cell 17 (47.2%), small cell 8 (22.2%), mixed 1 (2.8%), and undetermined 10 (27.8%). Factors associated with NECs were age > 40 years (P = 0.016), extra-pancreatic origin of the lesion (P = 0.014), and small cell histologic type (P < 0.001).
CONCLUSION
The most common site of PHB-NET detected through EUS was the pancreas. Although most were benign, about one-third were high-grade cancers. Insulinoma was the most common functioning tumor. NECs were associated with advanced age, extra-pancreatic origin, and small-cell histology.
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