Cystic Neuroendocrine Tumor of the Pancreas: A Rare Type of Pancreatic Cystic Lesion Accurately Diagnosed and Staged by EUS-FNA

Introduction Frequency of detection of pancreatic cystic lesions increased recent years. The majorities are pseudocysts, the remaining cysts are mainly neoplasms. Proven risk of malignancy affects intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN). Material and methods 145 patients operated on at the Department of General and Transplant Surgery in Barlicki Hospital in Lodz, Poland, in 2007-2016 due to pancreatic cystic lesion. The type of surgery, histopathological diagnosis and basic demographic data were analyzed. Results Nonneoplastic cyst (mainly pseudocysts) was found in 66.9% of patients, neoplasms were detected in 33.1%. The mean age was significantly higher in patients with neoplasms than without neoplasm (57.06 years vs. 50.88 years, p = 0.009). Neoplastic cyst occurred more frequently in women (68.75% of women, 31.25% of men, p = 0.001), Nonneoplastic cyst was found significantly more often in men (64.95% of men, 35.05% of women, p = 0.001). Malignant tumor was found in 14.58% of neoplasms cases. Pancreatic resections in neoplastic cysts were performed in 77,08%. In patients with nonneoplastic cysts drainage operations were performed most frequently (80.41%). Conclusions Neoplastic cysts are more common in women. The average age in the group of patients with neoplasms is higher than in the group with nonneoplastic cysts. In women with pancreatic cystic lesion without history for pancreatitis, the probability of neoplasms diagnosis is high. Discussion Pancreatic cystic tumors are treated radically due to the lack of sufficiently sensitive and specific pre-operative examinations. The natural history of mucinous neoplasms (IPMN and MCN) ranges from dysplasia to cancer. There are no guidelines that could be in satisfactory way used in follow up patients with pancreatic cysts.

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Abdominal desmoid in familial adenomatous polyposis presenting as a pancreatic cystic lesion

Familial Cancer ◽

10.1007/s10689-004-1923-z ◽

2005 ◽

Vol 4 (2) ◽

pp. 135-138 ◽

Cited By ~ 17

Author(s):

Lana N. Pho ◽

Cheryl M. Coffin ◽

Randall W. Burt

Keyword(s):

Familial Adenomatous Polyposis ◽

Cystic Lesion ◽

Adenomatous Polyposis ◽

Pancreatic Cystic Lesion

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183 Laparoscopic Resection of Pancreatic Cystic Lesion

Journal of Gastrointestinal Surgery ◽

10.1016/s1091-255x(02)00386-4 ◽

2003 ◽

Vol 7 (2) ◽

pp. 315

Author(s):

Y Mou

Keyword(s):

Cystic Lesion ◽

Laparoscopic Resection ◽

Pancreatic Cystic Lesion

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Cystic lesions of pancreas: challenges in diagnosis and management

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i3.15315 ◽

2016 ◽

Vol 18 (3) ◽

pp. 53

Author(s):

S Bohara ◽

TY Tamang ◽

DK Maharjan ◽

SK Shrestha ◽

PB Thapa

Keyword(s):

Cystic Lesion ◽

Mucinous Cystadenoma ◽

Pancreatic Head ◽

College Teaching ◽

Serous Cystadenoma ◽

Pancreatic Tumors ◽

Pancreatic Cysts ◽

Cystic Lesions ◽

Pancreatic Cystic Lesion ◽

First Case

Introduction: Pancreatic cysts are common (2.5%). Cystic neoplasms represent 10% of cystic lesions and 1% of pancreatic tumors. However, it is difficult to differentiate benign cyst from malignant cystic lesions preoperatively.Objective: To study the cases of pancreatic cystic lesion who underwent various forms of pancreatic resection.Materials and Methods: Nine cases of pancreatic cystic lesion who presented to Kathmandu Medical College Teaching Hospital, Surgical Unit 3 within December 2014- November 2015 were evaluated. Four pancreatic cysts who underwent resection are discussed whereas not managed with resection are excluded.Results: There were 4 cases of pancreatic cyst who underwent pancreatic resection. First case underwent pancreaticoduodenectomy for pancreatic mucinous cystadenoma. However histopathological examination revealed a serous cystadenoma. In second case, pancreatic neck lesion suspected to be mucinous cystadenoma or pseudocyst in MRCP, with negative malignant cells in EUS guided FNAC underwent Central pancreatectomy and was found to be serous cystadenoma. The third case with suspected pseudocyst underwent Pancreaticoduodenectomy after a 3X2 cm2 cystic mass was felt at the posteroinferior side of pancreatic head and malignancy was suspected intraoperatively . HPE report was mucinous cystadenoma. The fourth case with pancreatic pseudocyst at tail with duct calculi and chronic pancreatitis underwent distal pancreatectomy with splenectomy with Frey’s procedure.Conclusion: Management of pancreatic cystic lesion is challenging. Though radiological imaging has limited role in accurate diagnosis, endoscopic ultrasound may be of some benefit.

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Primary hepatic neuroendocrine tumor

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-20-0220 ◽

2021 ◽

Vol 2021 ◽

Author(s):

Le Tuan Linh ◽

Nguyen Minh Duc ◽

Hoang Tu Minh ◽

Nguyen Ngoc Cuong ◽

Vuong Thu Ha ◽

...

Keyword(s):

Neuroendocrine Tumor ◽

Clinical Symptoms ◽

Final Diagnosis ◽

List Type ◽

Rare Type ◽

Imaging Characteristics ◽

Imaging Results ◽

Long Term Follow Up ◽

Conclusive Diagnosis ◽

Primary Hepatic Neuroendocrine Tumor

Summary Primary hepatic neuroendocrine tumor (PHNET) is a rare type of neuroendocrine tumor (NET) that is also a primary hepatic tumor. Patients are present with almost no specific clinical symptoms and typically present with negative test results and atypical imaging characteristics; therefore, the differentiation of PHNET from other types of primary hepatic masses can be very difficult. In this article, we describe a case of PHNET that mimicked a liver helminth infection in a 57-year-old man. The diagnosis of PHNET in this patient was challenging, and the final diagnosis was based on imaging, histopathology features, and long-term follow-up. Learning points An uncommon type of neuroendocrine tumor (NET) is a primary hepatic neuroendocrine tumor (PHNET). Primary hepatic neuroendocrine tumors are rare NET lesions found in the liver, characterized by non-specific clinical and imaging results, which can be easily confused with other liver lesions, including HCC and parasitic lesions. To have a conclusive diagnosis and classification, a mixture of many medical assessment techniques, such as imaging, gastrointestinal endoscopy, nuclear medicine, anatomy, including histopathology, and immunohistochemistry, is essential.

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