Abstract
A case of a pure PP-oma of the pancreas was reported. The patient was 56 years old woman. She visited a near physician's office because of epigastralgia and back pain. There were no endocrine symptoms. Since abdominal ultrasonography showed a hypoechoic tumor in the head of the pancreas, she was admitted to our hospital for further examination. There was no abnormality in laboratory data on admission. CT revealed a sharply marginated hypodense lesion at plain scan and concentric interf low pattern at contrast-enhanced scan in the head of the pancreas. ERCP revealed stricture in both the pancreatic duct and the common bile duct. Angiography reveled a hypervascular lesion with early venous return in the head of the pancreas. MRI revealed a lesion of low intensity in Ti weighted, high intensity in T2 weighted in the head of the pancreas. EUS revealed a hypoechoic lesion in which the margin was distinctly observed with halo, lateral shadow and posterior enhancement, and the contour was smooth and the internal echo pattern was hetrogeneous. EUS was most useful in preoperative diagnosis of islet cell tumor of the pancreas. Pancreatoduodenectomy was performed. Histopathological examinations of the resected specimen revealed a tumor (30mm) of the head of the pancreas. Immunohistological examination revealed positive results in PP, and negative results in insulin, glucagon, gastrin, somatostatin, and VIP. Final diagnosis was pure PP-oma of the pancreas.
