Treatment of Multiple Endocrine Neoplasia Type 1 with a Non-Functioning Pancreatic Neuroendocrine Tumour That Is Growing or Larger Than 2 cm
In MEN1, non-functioning pancreatic neuroendocrine tumours present a distinct management challenge. When such tumours demonstrate active growth or exceed 2 cm in size, the clinical approach shifts meaningfully — and the decision requires careful, multidisciplinary evaluation.
Clinical scenario
MEN1 with a non-functioning pancreatic neuroendocrine tumour that is growing or larger than 2 cm in size. Surgical indications are determined through multidisciplinary team discussion involving shared decision-making with the patient.
Management approach (partial overview)
The approach in this setting centres on a surgical intervention, with pre-operative functional imaging used for staging before duodenopancreatic surgery — the specific imaging modality and full surgical strategy are detailed in the complete protocol.
The complete regimen, including the staging workup sequence and full surgical decision algorithm, is available via the structured protocol below.
References
DOI: 10.1016/S2213-8587(25)00119-6
- Surgery should be considered for growing non-functioning pancreatic neuroendocrine tumours and those larger than 2 cm in size, with the indications having been determined by a multidisciplinary team discussion that involved shared decision making with the patient.
- It is recommended that somatostatin receptor scintigraphy-PET–CT or somatostatin receptor scintigraphy-PET–MRI should be performed for staging in patients scheduled for duodenopancreatic surgery, as the outcomes might alter the surgical strategy.
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