Total Pancreatectomy for a Pancreatic Neuroendocrine Tumor with Agenesis of the Pancreatic Body and Tail

Abstract

The patient is a 50-year-old woman with pancreatic neuroendocrine tumor (pNET). She was scheduled to perform surgery for uterine cancer. The pancreatic tumor was detected on the preoperative examination. She had type2 diabetes mellitus, HbA1c 6.8％. CT showed an enhanced tumor, 35mm in diameter, in the pancreatic head and the absence of body and tail of the pancreas was detected. MRI showed a tumor, low intensity in T1 and high intensity in T2. Diffusion-weighted image revealed a high intensity tumor. EUS-FNA yielded a diagnosis of pNET G2. Based on the diagnosis of pNET G2 with agenesis of the pancreatic body and tail, we performed pylorus preserving total pancreatectomy with D2 lymphadenectomy. Resected specimen showed a solid tumor, 50mm in diameter, in the pancreatic head. Pathological findings showed chromogranineA (＋), synaptophisin (＋), and Ki-67 index 10％. She was given a diagnosis of the pNET G2, T2N0M0 Stage Ⅰb (AJCC/UICC TNM), non-functional. Two years after the surgery, there are no findings of recurrence and she is on a favorable course of nutrition and control of blood glucose.

We experienced the surgical case of pNET with agenesis of the pancreatic body and tail. We report this case with some knowledge.