A malignant pancreatic neuro-endocrine tumor with intraductal growth within the main pancreatic duct and tumor thrombus within the splenic vein

Abstract

A 71-year-old woman with ischemic colitis was admitted to our hospital for evaluation of a pancreatic tail tumor with splenic infiltration. Endoscopic ultrasonography revealed a heterogenous hypoechoic mass with an irregular, central echogenic area in the tail of the pancreas and a solitary hypoechoic mass within the lumen of the main pancreatic duct(MPD). Endoscopic retrograde pancreatography showed interruption of the MPD in the head of the pancreas. Biopsy of this lesion confirmed a pancreatic neuro-endocrine tumor(NET). A NET with intraductal growth into the MPD and splenic infiltration was diagnosed. The patient underwent curative surgery. Histopathological examination revealed the malignant NET with intraductal growth within the MPD and tumor thrombus within the splenic vein. The patient received no postoperative adjunctive chemotherapy and 11 months after surgery she is alive without recurrence.