Pace M1*, Franceschilli C1, Rosati E2, Matarazzo I2, Pilozzi E3, Cavallini M1 and Petrucciani N1
1Department of Medical and Surgical Sciences and Translational Medicine, St. Andrea University Hospital, Sapienza University of Rome, Italy 2Department of Radiology, Sant' Andrea Hospital, Sapienza University of Rome, Italy 3Department of Clinic and Molecular Medicine, University of Rome La Sapienza, ItalyFulltext PDF
Background: Cystic Pancreatic Neuroendocrine Tumors (PNET) is rare and their diagnosis might be challenging. The aim of this report is to present a case of cystic PNET and discuss the radiological characteristics of these tumors and the possible differential diagnoses. Case Report: A 57-year-old woman with nonspecific abdominal pain underwent Magnetic Resonance Imaging (MRI) showing a nodular lesion of the pancreatic tail, with a maximum diameter of 18 mm and main pancreatic duct dilatation. She repeated a magnetic resonance after 6 months showing increased cyst size (18 mm vs. 23 mm). Main Pancreatic Duct IPMN (MPD-IPMN) was considered the most probable diagnosis so she underwent distal pancreatectomy with spleen and splenic vessels preservation. Final histological exam showed a cystic neuroendocrine tumor. Cystic neuroendocrine tumor represents a challenging preoperative diagnosis. Most patients are asymptomatic or have nonspecific symptoms (abdominal pain, diarrhea, weight loss and asthenia). Computed tomography and magnetic resonance are not always diagnostic as these tumors may simulate other more frequent pancreatic cystic lesions. Conclusion: The present case underlines the clinical, radiological and histological characteristics of cystic PNETs, discussing the possible differential diagnoses, including pancreatic cyst, pancreatic pseudocyst, MPD-IPMN, solitary pseudopapillary tumor and mucinous cystic tumor.
Pancreas; Neuroendocrine pancreatic tumor; Pancreatectomy; Spleen preservation
Pace M, Franceschilli C, Rosati E, Matarazzo I, Pilozzi E, Cavallini M, et al. Cystic Pancreatic Neuroendocrine Tumor: A Challenging Diagnosis. World J Surg Surgical Res. 2022; 5: 1414..