2017 Volume 59 Issue 5 Pages 1321-1328
A 48-year-old woman was admitted to our hospital with epigastric pain with elevated serum liver enzymes and a dilated common bile duct. An abdominal CT scan showed that the intrahepatic and common bile ducts were dilated. T1-weighted MRI of the pancreas showed low signal intensity, whereas T2-weighted MRI of the pancreas showed high-signal-intensity spots in the pancreatic head. Overall, the branches of the pancreatic duct appeared to be dilated. Endoscopic ultrasonography showed that the common bile duct was 10 mm in diameter, and that the lower bile duct was compressed by the low-echoic mass located in the pancreatic head. These findings suggested that a tumor, located at the orifice of the papilla of Vater, had prolapsed and expanded into the main pancreatic duct up to the central portion of the pancreas. Endoscopic biopsy of the tumor thrombus in the main pancreatic duct showed that the tumor was a neuroendocrine tumor. Total pancreatectomy was performed. The pathological diagnosis was non-functional neuroendocrine tumor G2. We report here a rare case of intraductal growth of a pancreatic neuroendocrine tumor, which could be diagnosed preoperatively.
