A case of mixed adeno-neuroendocrine carcinoma of the pancreas with a ductal cell and large cell type neuroendocrine carcinoma component

Abstract

We report a rare case of pancreatic cancer, mixed adeno-neuroendocrine carcinoma. A 52-year-old man was admitted to our hospital because of a tumor of the pancreas body. Abdominal Computed tomography showed an unclear mass at artery phase but a well enhanced and unclearly demarcated 25mm tumor at portal phase in the body of pancreas. On magnetic resonance imaging, the lesion demonstrated high signal intensity on a T2-weighted image and diffusion image. On FDG/PET-CT, the tumor showed significantly high SUVmax=9.7. With a diagnosis of pancreatic carcinoma with high malignant potential, we performed a distal pancreatectomy. Histological and immunohistochemical examinations revealed that the tumor consisted of ductal component and neuroendocrine component. The neuroendocrine component corresponded to poorly differentiated neuroendocrine carcinoma, large cell type, based on morphological characteristics. By these findings, the tumor was diagnosed as mixed ductal-neuroendocrine carcinoma according to the current World Health Organization classification system.