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Open Access Case Report

Incidental intraoperative discovery of a pancreatic neuroendocrine tumor associated with chronic pancreatitis

Valeriu Surlin1, Sandu Ramboiu1, Mirela Ghilusi2 and Iancu Emil Plesea2*

Author affiliations

1 Department of Surgery, University of Medicine and Pharmacy of Craiova, Petru Rares 2, 200393, Craiova, Romania

2 Department of Pathology, University of Medicine and Pharmacy of Craiova, Petru Rares 2, 200349, Craiova, Romania

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Citation and License

Diagnostic Pathology 2012, 7:132  doi:10.1186/1746-1596-7-132

Published: 29 September 2012

Abstract

Pancreatic neuroendocrine tumors are a rare entity with an incidence between 2 per million to 5 per 100 000. Association with pancreatitis (acute or chronic) is rare and is considered to be determined by the tumoral obstruction of pancreatic ducts, but sometimes occurs without any apparent relationship between them. Non-functional neuroendocrine pancreatic tumors are usually diagnosed when either very large or metastatic. Small ones are occasionally diagnosed when imagery is performed for other diagnostic reasons. Intraoperative discovery is even rarer and poses problems of differential diagnosis with other pancreatic tumors. Association with chronic pancreatitis is rare and usually due to pancreatic duct obstruction by the tumor. We describe the case of a patient with a small non-functioning neuroendocrine tumor in the pancreatic tail accidentally discovered during surgery for delayed traumatic splenic rupture associated with chronic alcoholic pancreatitis. The tumor of 1.5cm size was well differentiated and confined to the pancreas, and was resected by a distal splenopancreatectomy.

Conclusions

Surgeons should be well aware of the rare possibility of a non-functional neuroendocrine tumor in the pancreas, associated with chronic pancreatitis, surgical resection being the optimal treatment for cure. Histopathology is of utmost importance to establish the correct diagnosis, grade of differentiation, malignancy and prognosis.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2114470176676003 webcite.

Keywords:
Pancreatic neuroendocrine tumor; Chronic pancreatitis; Splenopancreatectomy