[Cystic pancreatic tumor treated by distal spleno-pancreatectomy with occasional diagnosis of neuroendocrine tumor: case report].
BACKGROUND
Cystic and neuroendocrine pancreatic neoplasms are quite rare tumors which diagnosis is often difficult due to their non specific symptomatology and limited diagnostic accuracy of conventional diagnostic instruments. Their treatment is still controversial.


METHODS
A young woman is admitted with abdominal pain and dyspepsia. Instrumental diagnosis reveals a cystic pancreatic lesion which seems to be malignant as CEA of pancreatic liquid is increased. The patient undergoes distal spleno-pancreatectomy and postoperative histological examination found IPMN associated with MCN and furthermore there was occasional diagnosis of a small neuroendocrine tumor in the pancreatic tail.


CONCLUSIONS
A correct diagnostic approach is indispensable for a correct therapeutic approach. Radical surgical treatment is indicated in all cases of main- and branch duct IPMN and in case of MCN with signs of malignant transformation. Surgical treatment is also the gold standard for pancreatic neuroendocrine tumors if they are singular and in M0 stage.


CONCLUSIONS
In case of cystic and neuroendocrine neoplasms of the pancreas the preoperative diagnostic approach is often not enough to obtain a definite diagnosis. Review of literature and this case report show that a definite diagnosis can only be done after postoperative histological examination. Recent prospective studies suggest the possibility for a follow up instead of surgical treatment for some neuroendocrine tumors.
Istituto di Patologia Chirurgica AOU, Sassari.
Carlo
C
Pala
Fernando
F
Serventi
Fabrizio
F
Scognamillo
Federico
F
Attene
Ilia Patrizio
IP
Pisano
Luigi
L
Cugia
Mario
M
Meloni
Mario
M
Trignano
D003537:Cystadenoma / Q000175:diagnosis / Q000601:surgery; D018291:Cystadenoma, Mucinous / Q000175:diagnosis / Q000601:surgery; D018292:Cystadenoma, Papillary / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000601:surgery*; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000601:surgery*; D010180:Pancreatectomy / Q000009:adverse effects; D010183:Pancreatic Ducts / Q000601:surgery; D010185:Pancreatic Fistula / Q000209:etiology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects; D016896:Treatment Outcome