Abstract
We present a case of liver metastases arising from pancreatic neuroendocrine tumor 24 years after the initial resection. The patient was a 64-year-old woman who had undergone pancreatico-duodenectomy for pancreatic neuroendocrine tumor of the pancreas head at 1988. The patient developed acute pancreatitis and was admitted to Hitachi General Hospital as emergency at April 2012. Several imaging examinations showed liver tumors at segment 7. Liver biopsy was undergone to confirm diagnosis of the liver tumors, because it was difficult to clarify diagnosis only from imaging findings. Immunohistochemically, the tumor cells were positive for markers of neuroendocrine such as chromogranin A, synaptophysin, CD56, and parakeratin. Therefore, we suspected the liver tumors as metastases from pancreatic neuroendocrine tumor resected 24 years before. We performed partial hepatectomy. The histological findings were similar to those of the primary pancreatic neuroendocrine tumor resected 24 year before. The longest interval from the resection of pancreatic neuroendocrine tumor to its liver metastases was recorded in this case. We should recognize such a rare type of metastases when it is difficult to confirm the diagnosis of liver tumor.
