2016 Volume 58 Issue 10 Pages 2154-2160
A 40-year-old man visited our emergency room because of left flank pain. His laboratory data showed elevated inflammatory reaction. Ultrasound, CT and MRI examinations showed a mildly enhanced mass in the pancreas body with retention cysts in the pancreas tail. Endoscopic retrograde cholangiopancreatography showed irregular filling defect in the main pancreatic duct in the head and body, disruption of the main pancreatic duct in the body, and a hemorrhagic mass that protruded from the duodenal papilla. Based on biopsy examination of the mass and cytology of the pancreatic juice, we strongly suspected that this mass was a pancreatic neuroendocrine tumor.
Although there was metastasis in the left hepatic lobe, we performed total pancreatectomy and partial hepatectomy for the purpose of radical excision and pain control. The final diagnosis was pancreatic neuroendocrine tumor (WHO classification grade 2). The patient is alive for 17 months after the operation. We report this rare case of pancreatic neuroendocrine tumor with intraductal extension accompanied by tumor exposure to the duodenal papilla.
