Pancreatic Neuroendocrine Tumor with Benign Serous Cystadenoma: A Rare Entity

Abstract

Mixed serous-neuroendocrine neoplasm constitutes pancreatic serous cystic neoplasms and pancreatic neuroendocrine tumor, two tumor components with different underlying pathologies. The differentiation of these tumors is important as the management and prognosis depend on the pancreatic neuroendocrine tumor component. We report a case of mixed serous-neuroendocrine neoplasm in a 47-year-old female who presented with epigastric pain abdomen for two years. Imaging studies, tumor markers, thorough systemic evaluation, surgical resection, histopathological examination, and timely follow-up constituted our management approach. A 4 cm × 4 cm mass in the distal pancreas with multiple cysts in the pancreatic parenchyma containing serous fluid on distal pancreatectomy and splenectomy was found. The histopathological examination revealed combined benign serous cystadenoma and neuroendocrine tumor. She did not have any recurrence or metastasis by four years of follow-up.

Massive pancreatic serous cystadenomas raise important questions regarding surgical management of incidental pancreatic cystic lesions: a report of two cases

“…Since the advent of increasingly reliable diagnostics, surgeons have recommended selective resection of benign lesions with faster growth or those that might require more complex resection with higher risk for surgical complication down the road ( 9 , 10 ). However, there is still risk for missed malignancies such as the neuroendocrine carcinoma discovered on surgical pathology of the second patient presented here and similar to one reported by Yadav et al ( 15 ). Additional rationale behind early intervention includes reducing risk of non-operative complications such as pain, early satiety, biliary obstruction, atrophy of normal pancreatic parenchyma leading to exocrine and endocrine dysfunction, and erosion of tumor vessels resulting in catastrophic hemorrhage ( 16 - 19 ).…”

Therapeutic experience of a pancreatic mixed serous neuroendocrine neoplasm invading peripancreatic vessels: A case report

“…In theory, once the diagnosis of PMSNN is made, surgical treatment is preferred. However, so far only a very few cases of surgical treatment for PMSNN have been reported in the literature, [3][4][5] and it is unclear whether there is invasion of important surrounding vessels. In addition, there are no reports on the surgical treatment of peripancreatic vessels invasion.…”