A case of somatostatin and calcitonin-producing endocrine carcinoma expanding into the main pancreatic duct

Abstract

A 64-year-old male was admitted to our hospital because an asymptomatic tumor located in the pancreatic tail, was found on computed tomography. Magnetic resonance cholangiopancreatography revealed obstruction of the main pancreatic duct in the pancreatic tail ; there were no abnormal findings in the body or the head of the pancreas. The patient's serum somatostatin and calcitonin levels were elevated. A distal pancreatectomy with aplenectomy was performed. During surgery, a tumor thrombus was found in the main pancreatic duct ; two additional resections were required to obtain a negative margin. The resected specimen included a tumor thrombus in the pancreatic duct that extended 4 cm from the edge of the tumor margin. On histology, the tumor was diagnosed as a well-differentiatied endocrine carcinoma ; it was positive for somatostatin and calcitonin on immunohistchemistry. It is likely that, in this patient, the tumor extended into the pancreatic duct over a rather short period of time. Endocrine tumors which clinically simultaneously produce somatostatin and calcitonin are rare.