Cystic pancreatic neuroendocrine neoplasms with uncertain malignant potential: Report of two cases

Abstract

Neuroendocrine tumors of the pancreas (NETP) represent only 1%-2% of all pancreatic neoplasms. They can be classified as functioning or non-functioning, respectively, according to the presence or absence of paraneoplastic syndrome. Case 1 concerned a 70-year-old woman with a cystic lesion of the pancreatic head and body. All tumor markers were negative. The patient underwent a distal pancreatectomy. The histology revealed a well-differentiated endocrine tumor with uncertain malignant potential. Case 2 was a 61-year-old man with chronic polyserositis. The serum tumor markers were negative, while he was strongly positive for intracystic tumor markers carcinoembryonic antigen, carbohydrate antigen (CA) 19-9, and CA 125. The patient underwent a cephalo-pancreatic duodenectomy. The preoperative differential diagnosis of cystic NETP is still a challenge due to the high rate of the nonfunctional variant. Although cystic NETPs are well differentiated, they are still tumors with a malignant potential, and therefore an early diagnosis and radical surgical resection could be associated with a better long-term survival.

Mixed acinar-endocrine carcinoma of the pancreas with intraductal growth into the main pancreatic duct: Report of a case

“…17 Normally, the survival of patients with acinar cell carcinoma is reported to be from 18 to 19 months, 18 and therefore, judging from these cases 16,17 the outcome is not extremely poor, even though patients develop an intraductal invasion. On the other hand, endocrine carcinoma also grows expansively, 19,20 showing little change in the pancreatic duct other than replacement. However, in some reports endocrine carcinoma was observed to have invaded/expanded to the pancreatic duct, and such endocrine carcinomas are considered to be highly malignant.…”

Pancreatic neuroendocrine cell tumor secreting parathyroid hormone-related protein and gastrin: Report of a case

“…1,2 Functional NET of the pancreas has clinical symptoms associated with the oversecretion of various hormones, such as insulin, gastrin, glucagon, and somatostatin. Hypercalcemia is caused by primary hyperparathyroidism as part of the syndrome of multiple endocrine neoplasia (MEN) type I.…”

Pancreatic neuroendocrine tumour simulating an intraductal papillary mucinous neoplasm

“…Most cases occur in middle age individuals, with a slight female preponderance [2]. The cystic degeneration of these tumours is a much less frequent phenomenon, occurring in 2-10% of all cases.…”