Pancreatic neuroendocrine tumor - well differentiated
Chronic epigastric pain with postprandial vomiting and fever. Palpable mass.
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There is a large solid and cystic mass in the pancreatic head with focal calcification. The solid components show arterial enhancement (hypervascularity). There is moderate dilatation of the main pancreatic duct.
Other CT findings are periportal intrahepatic edema and pericholecystic fluid.
No evidence of vascular invasion. No hepatic metastases.
Well-differentiated pancreatic neuroendocrine tumors comprise of ∼1-3% of pancreatic neoplasms. Depending on the cell of origin they may be malignant. The treatment of choice for a localized pancreatic head tumor (as in this case) is a Whipple's procedure (pancreaticoduodenectomy).
This tumor was functional (synaptophysin and chromogranin positive). There was not a dominant tissue type and it was not syndromic.