A Small Pancreatic Neuroendocrine Tumor with Marked Pancreatic Duct Dilatation and Parenchymal Atrophy.
- Author:
Sunghyun WON
1
;
Seung Mo HONG
;
Myung Hwan KIM
;
Sangwoo PARK
;
Yunsik CHOI
;
Il Young JANG
;
Hyoung Jung KIM
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. mhkim@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Pancreatic duct dilatation;
Pancreas neuroendocrine tumor;
Serotonin
- MeSH:
Adenocarcinoma;
Atrophy*;
Biopsy, Fine-Needle;
Dilatation*;
Fibrosis;
Head;
Neuroendocrine Tumors*;
Pancreas;
Pancreatic Ducts*;
Pancreaticoduodenectomy;
Serotonin
- From:Korean Journal of Medicine
2014;86(5):598-602
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Pancreatic ductal adenocarcinomas often cause marked pancreatic duct dilatation and associated parenchymal atrophy. We present the case of a small pancreatic neuroendocrine tumor with upstream pancreatic duct dilatation and severe parenchymal atrophy. A small enhancing tumor was observed at the head of the pancreas on computed tomography (CT). Endoscopic ultrasonography-guided fine-needle aspiration was negative for malignancy. We performed a pylorus-preserving pancreatoduodenectomy since we could not exclude the presence of pancreatic ductal adenocarcinoma. The pathological and immunohistochemical examination revealed a serotonin-positive neuroendocrine tumor, measured 1.0 x 0.5 cm. The pathological specimen was remarkable for the marked stromal fibrosis in the area of the tumor, which resulted in narrowing of the main pancreatic duct. Here, we report a rare small pancreatic neuroendocrine tumor, the CT image of which resembled that of pancreatic ductal adenocarcinoma, in which the expression of serotonin and associated fibrosis might be a possible mechanism for the marked main pancreatic duct dilatation.
