Anatomic distribution of pancreatic endocrine tumors

Thomas J. Howard, Bruce E. Stabile, Michael J. Zinner, Steven Chang, Belur S. Bhagavan, Edward Passaro

Research output: Contribution to journalReview articlepeer-review


Pancreatic endocrine tumors are grouped together by their common histologic, cytochemical, and ultrastructural features. Although useful conceptually, this paradigm has been unable to predict the anatomic location of different tumor types. Successful surgical excision of these tumors would be facilitated by an improved understanding of their anatomic distribution. Based on the available data, a bimodal distribution of pancreatic endocrine tumors was identified. Cluster 1 (gastrinomas, pancreatic polypeptide (PP)-secreting tumors, somatostatinomas) had 75% of tumors to the right of the superior mesenteric artery, whereas cluster 2 (insulinoma, glucagonoma) had 75% of tumors to the left of the superior mesenteric artery (p<0.05). This distribution is similar to that distribution predicted based on the volume density of the corresponding islet cells for insulinoma, glucagonoma, and PP-secreting tumors, but not for somatostatinoma. These findings suggest that pancreatic endocrine tumors are derived from similar cytologic precursors as pancreatic islet cells, and their distribution may be a consequence of embryologic development from either the ventral (cluster 1) or dorsal (cluster 2) pancreatic buds.

Original languageEnglish (US)
Pages (from-to)258-264
Number of pages7
JournalThe American Journal of Surgery
Issue number2
StatePublished - Feb 1990

ASJC Scopus subject areas

  • Surgery


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