Pancreatic Neuroendocrine Tumor with Atypical Radiologic Presentation

Singh, Ramandeep; Calhoun, Sean; Shin, Minchul; Katz, Robert S.

doi:10.2484/rcr.v3i3.162

Cited by 12 publications

(15 citation statements)

References 10 publications

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“…Only one other case has been documented to the best of our knowledge showing diffuse replacement of the pancreas with neuroendocrine tumour. 1 Clinically, the patient presented only with recurrent abdominal pain; she had no history of diabetes, diarrhea or malnourishment, symptoms often seen in patients with chronic pancreatitis. 10 Additionally, her social history was negative for any significant consumption of alcohol, one of the more significant risk factors for chronic pancreatitis.…”

Section: Discussionmentioning

confidence: 98%

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Imitators of chronic pancreatitis: diffuse neuroendocrine tumour of the pancreas

et al. 2017

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We report a rare case of diffuse replacement of the pancreas with neuroendocrine tumour mimicking chronic pancreatitis. A 55-year-old female with no significant past medical history initially presented with abdominal pain in 2006. A CT of the abdomen and pelvis was performed, revealing diffuse pancreatic parenchymal calcifications with mild pancreatic ductal dilatation and no discrete mass. She was diagnosed with chronic pancreatitis and followed clinically until 2015, where she presented with recurrent abdominal pain. A repeat CT and MRI of the abdomen were performed which revealed new hypoenhancing masses within the pancreas, particularly in the pancreatic tail. There was a persistent background of pancreatic parenchymal calcifications. The possibility of pancreatic neuroendocrine tumour was raised, and an indium-111 Octreotide scan was recommended. Diffuse intense uptake was identified throughout the pancreas on the indium-111 imaging. Given the concern for neuroendocrine tumour, a total pancreatectomy was performed, with histopathology revealing replacement of the pancreas with coalescing well-circumscribed nodules. Many of the nodules had numerous calcifications and localized amyloid deposition. Immunohistochemical stains of the neoplastic cells were strong for neuroendocrine markers chromogranin A and synaptophysin. Overall the findings were consistent with numerous neuroendocrine tumours of the pancreas, Grade II, as per the 2010 WHO criteria for neuroendocrine tumours of the pancreas. Neuroendocrine tumours of the pancreas are lesions that arise from the islet cells, with an approximate incidence of five cases per million people per year. Only one other case report has been documented in the literature by Singh et al demonstrating diffuse pancreatic neuroendocrine tumour replacing the entire pancreas. As diffuse pancreatic neuroendocrine tumour can look similar on imaging to chronic pancreatitis or other infiltrative processes, we wanted to present this case and some of the more specific imaging findings in distinguishing these entities.

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Section: Discussionmentioning

confidence: 98%

“…Pancreatic neuroendocrine tumours are rare tumours arising from pancreatic islet-cells, with an incidence of approximately five cases per million per year. 1 These tumours represent about 1.5% of all gastrointestinal and pancreatic neoplasms. 2 – 4 The majority of pancreatic neuroendocrine tumours have no known risk factors.…”

Section: Discussionmentioning

confidence: 99%

Imitators of chronic pancreatitis: diffuse neuroendocrine tumour of the pancreas

et al. 2017

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“…[ 10 ] Diffuse pancreatic infiltration with neuroendocrine tumor is a rare presentation, previously reported once on anatomic imaging. [ 6 11 ] Diffuse uptake of In-111 pentetreotide has previously been reported in the lungs,[ 12 13 ] but diffuse uptake in the pancreas from a neuroendocrine tumor has not been reported previously. In conclusion, this case highlights a rare presentation of a well-differentiated, low-grade neuroendocrine tumor as the diffuse involvement of the pancreas, with local invasion, but no nodal or distant metastasis.…”

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confidence: 99%

Diffuse pancreatic neuroendocrine tumor: A rare presentation

et al. 2018

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“…7 Rarely, PanNET may present as diffuse infiltrative variety in which the entire pancreatic tissue is enlarged and replaced by calcifications and cysts. 8…”

Section: Discussionmentioning

confidence: 99%

Unusual Case of a Pancreatic Neuroendocrine Tumor Containing a Central Scar

et al. 2019

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We report a previously unreported case of a pancreatic neuroendocrine tumor with a central scar mimicking a serous neoplasm. To our knowledge, this atypical imaging morphology of pancreatic neuroendocrine tumor has not been described before. Our report adds to the body literature that describes atypical imaging variants of neuroendocrine tumors and highlights that clinicians should be aware of the broad imaging characteristics of neuroendocrine tumors.

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Pancreatic Neuroendocrine Tumor with Atypical Radiologic Presentation

Cited by 12 publications

References 10 publications

Imitators of chronic pancreatitis: diffuse neuroendocrine tumour of the pancreas

Imitators of chronic pancreatitis: diffuse neuroendocrine tumour of the pancreas

Diffuse pancreatic neuroendocrine tumor: A rare presentation

Unusual Case of a Pancreatic Neuroendocrine Tumor Containing a Central Scar

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