need advice - suggestive of Islet cell tumor

[TSWH]

thank you in advance for your time and consideration.

in a 55 year old white male, a vegetarian for the last 30+ years, no smoking, no drinking, extremely fit to the point of being 20 pounds underweight for height due to diet and continuous exercise, with a resting hr in the low 50s and a systolic blood pressure in the 80s, no pancreatic cancer symptoms by history. (history of mumps when a 4 or 5 year old.) on ct exam, a mass (1.8cm) with calcification found in the body of the pancreas. on biopsy (fna), the pathologist reports: clusters of spindle cells, cells with granular cytoplasm, insufficient cellularity. blood only. lesional tissue present oa/ll. moderately cellular smear with numerous stripped nuclei and scattered dyscohesive cells showing eccentrically placed nuclei, finely granular cytoplasm and inconspicuous nucleoi, findings suggestive of islet cell tumor, see note. clusters and individual acinar cells are identified. note; immunohistochemical study performed on one of the smears shows positive immunotreactivity with synaptophysin supporting neuroendocrine differentiation of the lesion.

despite no signs or symptoms and no markers found on various blood tests, based on the pathology report the suggested plan of care is surgery to remove the mass.

1. would appreciate an explanation of what would drive the medical team to a decision in the direction of surgery as the treatment option of choice given pathology report and the lack of signs/symptoms/markers.

2. any experience anyone has had with calcified tumors in the body of the pancreas.

3. any information anyone has on the 3-year, 5-year, 10-year survival rate for such masses?

4. any experience with operating to remove the tumor, only to then find metastasis present after all. if so, what were the treatment options and outcomes?

5. any information on what to expect in terms of recuperation? how long in the hospital? how long recuperating outside the hospital?

6. does anyone know of any facilities in manhattan that would take in a patient after discharge from the hospital? how long / any restrictions on duration of stay?

7. how long before return to "normal" including living in a 5th floor walk up apartment and riding a bicycle 1 mile each way to work?

8. any other sources of information i should consult besides pancreatica, pancreasefoundation, onconurse, merck, etc.?

9. any medications likely to be needed post op and on discharge?

10. likely follow up routine, e.g., what labs, cts, mris, xrays, and what frequency, e.g., 3 months, 12 months, 24 months?

thank you all very much.

[EricJRN, MSN, RN]

Just wanted to wish you well in your treatment. Although the Terms of Service for this website prohibit us from dispensing medical advice, I wanted to encourage you to run these questions by your treatment team. If you're unable to communicate adequately with your physician, it's probably a sign that it's time to shop for another one.