Management of incidental pancreatic neuroendocrine tumor: a case report with literature review

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Published: Nov 13, 2023
Keywords:
Case report, Management, Neuro Endocrine, NET, Pancreatic Neuro Endocrine Tumor, PNET

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Erasmo Spaziani
Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, Sapienza University of Rome, Terracina, Italy
Annalisa Romina Di Filippo
Unit of Anesthesia, Intensive Care and Pain Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Rome, Italy
Martina Spaziani
Unit of Anesthesia, Intensive Care and Pain Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Rome, Italy
Giovanni Traumueller Tamagnini
Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, Sapienza University of Rome, Terracina, Italy
Piero Francioni
Department of Radiology, AUSL Latina, “A. Fiorini” Hospital, Terracina, Italy
Nello Salesi
Department of Oncology, Hospital “S. Maria Goretti”, Latina, Italy
Marcello Picchio
Division of Surgery, ASL Roma 6, “P. Colombo” Hospital, Velletri, Italy
Alessandro De Cesare
Department of Surgery “Pietro Valdoni”, Sapienza University of Rome, Rome, Italy

Abstract

BACKGROUND: Pancreatic neuroendocrine tumors (PNETs) are rare and accounting for less than 5% of all pancreatic neoplasms. Their management depends on dimension of the lesion, main pancreatic duct (MPD) caliber, tumor malignancy features and evolutive potential.


CASE REPORT: Incidental finding of a lesion 1.2 cm wide of the pancreatic body, after contrast enhanced total body CT, in a 71 years old obese Caucasian male (BMI>25), during follow-up for cutaneous melanoma. The lesion was confirmed by MRI and 68-Ga pancreatic scintigraphy. EUS showed a second hypoecogenic and hypovascularized lesion compatible with pancreatic tail PNET. After FNB, Ki-67 was below 3%.


DISCUSSION: 68-Gallium PET-CT was the preferred technique for the staging of the neuroendocrine neoplasm, for treatment planning, for the localization of the pancreatic lesion, excluding the presence of unknown extra-pancreatic lesions. EUS-FNB is indicated in patient with suspicion of PNET, although further investigation is needed to include it as a routine diagnostic examination.


CONCLUSION: Surgery is mandatory in case of PNETs larger than 2 cm, with MPD dilation, Ki-67>20% and compression symptoms.

Article Details

How to Cite
Erasmo Spaziani, et al. “Management of Incidental Pancreatic Neuroendocrine Tumor: A Case Report With Literature Review”. Annali Italiani Di Chirurgia, vol. 12, no. November, Nov. 2023, pp. 1-5, https://annaliitalianidichirurgia.it/index.php/aic/article/view/599.
Issue
Vol. 12 No. November (2023)
Section
Case Report