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Pancreatic neuroendocrine tumor

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Abdominal and back pain.

Patient Data

Age: 25 years
Gender: Female

Within the medial aspect of the pancreatic head, there is an arterially peripherally hyper-enhancing mass with some internal central coarse calcifications and central low attenuation.

No other pancreatic lesion identified. Mild prominence only of the main pancreatic duct at the level of the pancreatic neck and proximal body. No abnormal biliary dilatation. No focal liver lesion or enlarged regional lymph nodes.

Case Discussion

The patient underwent EUS and biopsy followed by Whipple's procedure. 

Histopathology:

Pancreatoduodenectomy specimen:

  • Grade 1 pancreatic neuroendocrine tumor
  • 24 mm in maximum dimension
  • Present at the vascular groove margin
  • Clear of all other margins
  • Perineural invasion identified.
  • No lymphovascular invasion
  • 14 lymph nodes isolated, none of which contain metastatic carcinoma (0/14)

Besides pain, the patient was asymptomatic and it was considered non-functional. 

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