title: Neuroendocrine carcinoma of the pancreas with soft tissue metastasis.
abstract: Neuroendocrine carcinoma (NEC) of the pancreas is rare. We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis. The patient presented with right upper abdominal discomfort. Computed tomography revealed a low-density heterogeneous mass in the tail and body of the pancreas that encroached on the greater curvature of the stomach and spleen. We performed exploratory laparotomy and total pancreatectomy with splenectomy and total gastrectomy. Histopathological analysis showed spindle-shaped cells with scanty cytoplasm and hyperchromatic nuclei, confirming a primary pancreatic NEC. One month after the surgery, the patient experienced leg swelling. Positron emission tomography-computed tomography revealed high uptake of fludeoxyglucose in the left leg, and the leg was amputated. Histopathological analysis confirmed metastasis of pancreatic NEC. The patient was followed up and received chemotherapy (etoposide and cisplatin). One month after amputation, the level of tumor marker neuron-specific enolase was 142.70 μg/L and computed tomography scan revealed an aggravated metastatic lesion. The patient suffered from unbearable pain and we treated him with odynolysis. Four months postoperatively, the patient died of respiratory failure.
authors.affiliation: Department of Surgery, Shanghai 6th People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Qi
authors.initials: Q
authors.lastname: Zheng
authors.forename: Zhe
authors.initials: Z
authors.lastname: Yang
authors.forename: Xin-Yu
authors.initials: XY
authors.lastname: Huang
authors.forename: Zhou
authors.initials: Z
authors.lastname: Yuan
authors.forename: Juan
authors.initials: J
authors.lastname: Tang
mesh_terms: D000328:Adult; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis* / Q000473:pathology; D002945:Cisplatin / Q000494:pharmacology; D005047:Etoposide / Q000494:pharmacology; D006801:Humans; D007813:Laparotomy; D008297:Male; D009362:Neoplasm Metastasis; D010179:Pancreas / Q000378:metabolism; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D010751:Phosphopyruvate Hydratase / Q000378:metabolism; D049268:Positron-Emission Tomography; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D010751:Phosphopyruvate Hydratase; D002945:Cisplatin