Abstract
Pancreatic neuroendocrine tumors (pNETs) are rare but their detection has increased due to the development of medical checkup systems, and they are therefore garnering attention recently. Typical cases of nonfunctioning pNET appear to have an asymptomatic clinical course. We encountered a case of nonfunctioning pNET wherein the patient initially seemed to have intra-abdominal hemorrhage.
The patient was a 62-year-old woman who presented with sudden epigastric pain and was admitted to our hospital. Her left upper abdomen showed muscular defense. Laboratory data were almost normal, except for peripheral blood revealing slight anemia. CT revealed an enhanced mass that measured 80 mm in diameter and arose from the pancreatic tail, with bloody ascites adjacent to the tumor. Under the diagnosis of nonfunctioning pNET with intra-abdominal hemorrhage and without symptoms other than an excess of islet cell hormones, distal pancreatectomy combined with splenectomy was performed electively. The cut surface of the tumor showed scattered blood coagula. Histologically, the final diagnosis was well-differentiated neuroendocrine tumor (G2). Although the patient developed multiple metastasis of the liver at 5 months after the operation, no further treatment was performed and she died at 48 months after the operation.
