Abstract
A 54-year-old woman was diagnosed as having an endocrine tumor in the pancreatic body due to an incidental finding on abdominal CT. Further evaluation revealed hepatic metastases ; caudal to the pancreatic body tumor, the parenchyma and the main pancreatic duct were absent. She was diagnosed as having an endocrine tumor and agenesis of the body and tail of the pancreas. The planned treatment included resection of the pancreatic tumor and hepatic infusion of chemotherapy for the liver metastases.
At surgery, a palpable indurated mass in the pancreatic body was noted. Caudally, thick adipose replacement tissue was found without the presence of pancreatic parenchyma or a main pancreatic duct. The mid-portion of the pancreas was resected ; a pancreatic-enteric reconstruction was not performed. The histopathological diagnosis was a well-differentiated neuroendocrine carcinoma. The caudal aspect of the lesion was almost completely replaced with fatty tissue. Some islets of Langerhans were present, but there were no pancreatic exocrine cells.
Postoperatively, the patient had good pancreatic exocrine function, without glucose intolerance. We present this rare case of a pancreatic endocrine tumor with fatty replacement in the pancreatic body and tail, in which a middle pancreatectomy without a distal pancreatic-enteric reconstruction was performed.
