Pancreatic neuroendocrine neoplasm with a ring-like enhancement pattern: a case report

Abstract

A 50-year-old woman with back pain who was followed for schizophrenia and obesity was admitted to the hospital. Abdominal computed tomography (CT) scan revealed a 25mm tumor in the pancreatic head. Contrast-enhanced magnetic resonance imaging (MRI) in the arterial phase showed a ring-like enhancing tumor with a hypovascular area in the central portion. Positron emission tomography-CT scan showed the tumor with a maximal standardized uptake value of 8.61. Carbohydrate antigen 19-9 level was elevated to 40U/ml. We diagnosed this lesion as a nonfunctional pancreatic neuroendocrine neoplasm or pancreatic ductal adenocarcinoma and performed a subtotal stomach-preserving pancreaticoduodenectomy. Histopathological findings revealed a pancreatic neuroendocrine neoplasm, with atypical cells in the enhanced area and fibrosis in the hypovascular area as seen on the contrast-enhanced MRI in the arterial phase. We report a patient with a rare neuroendocrine neoplasm with a ring-like enhancing pattern.