Sandbox: DDx pancrease

Differential Diagnosis	Clinical Presentation	Lab values	Imaging	Histopathology
Insulinoma	Weight loss Vague abdominal pain Loss of appetite Nausea and vomiting Jaundice Anxiety Diaphoresis Tremor Palpitations Seizures Coma	Decreased hemoglobin level Increased billirubin level (conjugated and total) Increase alkaline phosphatase Increased gamma-glutamyl transpeptidase Increased spartate aminotransferase Increased alanine aminotransferase Increased amylase and/or lipase Hypoglycemia Hyperinsulinemia Elevated C-peptide level Elevated Pro-insulin level	CT scan: calcification and hyperattenuation of the mass MRI: Hypointense on T1-weighted image, hyperintense on T2-weighted MRI, and signal enhancement on T1 C+ image U/S: Homogeneously hypoechoic mass rounded in shape with distinct margins	Solid or gyriform patterns, usually without glands
VIPoma	<1.5 cm² residual tumor after resection	Subtotal resection or >1.5 cm² residual tumor after resection	<1.5 cm² residual tumor after resection	Subtotal resection or >1.5 cm² residual tumor after resection
Tumor stage	M0 stage confirmed by MRI and CSF sampling	M1-M3 stage or presence of leptomeningeal seeding	M0 stage confirmed by MRI and CSF sampling	M1-M3 stage or presence of leptomeningeal seeding