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KMID : 0882420140860050598
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Korean Journal of Medicine
2014 Volume.86 No. 5 p.598 ~ p.602
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A Small Pancreatic Neuroendocrine Tumor with Marked Pancreatic Duct Dilatation and Parenchymal Atrophy
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Won Sung-Hyun
Hong Seung-Mo
Kim Myung-Hwan
Park Sang-Woo
Choi Yun-Sik
Jang Il-Young
Kim Hyoung-Jung
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Abstract
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Pancreatic ductal adenocarcinomas often cause marked pancreatic duct dilatation and associated parenchymal atrophy. We present the case of a small pancreatic neuroendocrine tumor with upstream pancreatic duct dilatation and severe parenchymal atrophy. A small enhancing tumor was observed at the head of the pancreas on computed tomography (CT). Endoscopic ultrasonographyguided fine-needle aspiration was negative for malignancy. We performed a pylorus-preserving pancreatoduodenectomy since we could not exclude the presence of pancreatic ductal adenocarcinoma. The pathological and immunohistochemical examination revealed a serotonin-positive neuroendocrine tumor, measured 1.0 × 0.5 cm. The pathological specimen was remarkable for the marked stromal fibrosis in the area of the tumor, which resulted in narrowing of the main pancreatic duct. Here, we report a rare small pancreatic neuroendocrine tumor, the CT image of which resembled that of pancreatic ductal adenocarcinoma, in which the expression of serotonin and associated fibrosis might be a possible mechanism for the marked main pancreatic duct dilatation.
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KEYWORD
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Pancreatic duct dilatation, Pancreas neuroendocrine tumor, Serotonin
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