Primary carcinoid tumour of the pancreas.
Pancreatic carcinoid tumours are extremely infrequent. Usually, the biological behaviour is indolent and diagnosis is late and often casual. We present the case of a patient initially diagnosed as having liver metastasis of unknown origin. PET identified a primary pancreatic site and the initial histologic diagnosis was adenocarcinoma. Following an uncertain response to chemo- and radio-therapy the repeat histologic assessment indicated a carcinoid tumour of the pancreas. After complete surgical resection and liver transplantation, patient remains free of disease.


CONCLUSIONS
The co-existence of several diseases with similar morpho-structural features makes diagnosis complicated. PET is of uncertain use in the evaluation of carcinoid tumours, and is considered inferior to 111Indium-octreotide scan. The only curative treatment is surgical resection, with liver transplantation as a valid option in the treatment of these tumours.
Pérez-Fidalgo
José Alejandro
JA
Sección de Oncología Médica, Hospital Virgen de los Lirios, Alcoy, Alicante, Spain. japfidalgo@msn.com
Oltra Ferrando
Amparo
A
López Jiménez
Antonio
A
Maestu Maiques
Inmaculada
I
D000230:Adenocarcinoma / Q000175:diagnosis; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002276:Carcinoid Tumor / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003951:Diagnostic Errors; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D049268:Positron-Emission Tomography; D012074:Remission Induction; D000093542:Gemcitabine
D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine