The pancreas is an important organ in the body that secretes pancreatic juice to aid in digestion, as well as having complex endocrine functions. Many organs in the body can grow malignant tumors, and the pancreas is no exception. In addition to the common pancreatic cancer, the possibility of pancreatic (neurological) endocrine tumors should be considered. The majority of pancreatic cancer originates from the ductal system of the exocrine glands of the pancreas. The malignancy of pancreatic cancer is high, and in addition to the pancreatic mass, clinical manifestations such as anorexia, emaciation, weakness, or pain in the upper abdomen, soreness of the back, or yellowing of the skin may occur. Pancreatic neuroendocrine tumors, which originate from endocrine cells (islet cells) of the pancreas, functional pancreatic neuroendocrine tumors include gastrinoma, insulinoma, glucagonoma, VIP tumor, etc., and the symptoms caused by the corresponding hormones are more prominent; while more than half of pancreatic neuroendocrine tumors are non-functional, and patients do not show endocrine hormone-related symptoms. Pancreatic neuroendocrine tumors are relatively rare and most of them are malignant, but the tumors develop slowly and the prognosis is much better than pancreatic cancer. Patients with pancreatic neuroendocrine tumors generally do not have high CA19-9 on laboratory tests, while serum CgA can be elevated, especially when there are obvious liver metastases. When a patient has ultrasound or CT to find something growing on the pancreas and the tumor markers CEA and CA19-9 are not high in the laboratory, the possibility of pancreatic neuroendocrine tumor should be thought of. Especially if the examination reveals pancreatic tumor and multiple liver metastases, while the patient is in good general condition and the laboratory CA19-9 is normal, then this rare disease should be highly suspected and further examination, such as laboratory serum CgA, pancreatic aspiration biopsy and ultrasound-guided hepatic aspiration biopsy, should be performed to confirm the diagnosis. Functional pancreatic endocrine tumors have specific hormonal syndrome manifestations, so the diagnosis is not difficult; non-functional pancreatic neuroendocrine tumors have no symptoms in the early stage and are diagnosed when the tumor enlarges and metastasizes, and the disease stage is often late, and a few patients with non-functional pancreatic neuroendocrine tumors in the early stage are mostly found by physical examination.