title: Incidental intraoperative discovery of a pancreatic neuroendocrine tumor associated with chronic pancreatitis.
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 1.5 cm 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.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2114470176676003.
authors.affiliation: Department of Surgery, University of Medicine and Pharmacy of Craiova, Petru Rares 2, 200393 Craiova, Romania.
authors.forename: Valeriu
authors.initials: V
authors.lastname: Surlin
authors.forename: Sandu
authors.initials: S
authors.lastname: Ramboiu
authors.forename: Mirela
authors.initials: M
authors.lastname: Ghilusi
authors.forename: Iancu Emil
authors.initials: IE
authors.lastname: Plesea
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000032:analysis; D002454:Cell Differentiation; D006801:Humans; D007150:Immunohistochemistry; D033162:Incidental Findings; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D019512:Pancreatitis, Alcoholic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011237:Predictive Value of Tests; D013161:Splenic Rupture / Q000209:etiology / Q000601:surgery; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor