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

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Erasmo Spaziani
Annalisa Romina Di Filippo
Martina Spaziani
Giovanni Traumueller Tamagnini
Piero Francioni
Nello Salesi
Marcello Picchio
Alessandro De Cesare


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.

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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,
Case Report