Multiple endocrine neoplasia type 1 CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

Abdominal CT scan may be helpful in the diagnosing pancreatic involvement of multiple endocrine neoplasia type 1. Findings on CT scan suggestive of pancreatic involvement of multiple endocrine neoplasia type 1 include thickened stomach rugal folds, multiple gastric nodules and calcified or cystic pancreatic tumors.

CT

• CT is used for suspected gastric, enteric and pancreatic neuroendocrine tumors with pre and post IV iodinated contrast.
• Bowel distension with fluid, either by oral intake (CT enterography) or via an nasojejunal tube (CT enteroclysis), improves detection of primary gastrointestinal neuroendocrine tumors.

Condition	CT Findings
Zollinger-Ellison Syndrome	Thickened rugal folds Multiple gastric nodules/masses
Insulinoma	Hyper-attenuating on arterial phase Calcifications
Pancreatic Islet Cell Tumors	Tumors tend to be smaller, hypervascular and may be calcified or cystic
Gastrinoma	Tumor size is variable, but the size of pancreatic lesions varies from 3-4 cm. The lesions are often hypervascular.
Glucagonoma	Tumor size is variable, but most of them are large and have metastasized at the time of diagnosis. Most of them are located in the distal pancreas and are vascular. Tumors may be solid or contain central low-attenuation areas on CT.: