Pancreatic endocrine tumor of uncertain behavior: a case report.
Pancreatic endocrine tumors are rare, and among them large non-functioning tumors of uncertain behavior are extremely infrequent. Non-functioning pancreatic endocrine tumors originate from the endocrine part of the pancreas but are not associated with a distinct hormonal syndrome. A rare case is presented of a 49-year-old woman with a well-differentiated endocrine tumor of uncertain behavior that presented with intermittent pain in the epigastrium radiating to the right subcostal region. Computed tomography showed a well-defined and circumscribed solid mass in the pancreas head. The pancreatic mass was surgically removed and submitted for histopathologic analysis. Microscopically, the tumor had relatively uniform cells with oval nuclei that coated trabecular and pseudoglandular structures, which also showed 1 mitosis per 10 VVP and proliferation activity measured with Ki67 of less than 2%. A focus of intravascular invasion was seen on one slide. Immunohistochemical analyses for NSE, chromogranin and synapthophysin were positive, which along with its size (over 2 cm in diameter) and reported angioinvasion indicated the diagnosis of pancreatic endocrine tumor of uncertain behavior. Although mostly considered as malignant, large non-functioning pancreatic endocrine tumors can sometimes express benign or uncertain behavior; therefore, a large number of factors should always be considered when determining the biological nature of these tumors.
Ledinsky
Mario
M
University Department of Surgery, Sestre milosrdnice University Hospital, Zagreb, Croatia. ledinsky@kbsm.hr
Coc
Ivan
I
Stancić
Vladimir
V
Borić
Marta
M
Tomas
Davor
D
D005260:Female; D006801:Humans; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery