title: Neuroendocrine tumor G3: a pancreatic well-differentiated neuroendocrine tumor with a high proliferative rate.
abstract: A 68-year-old man was referred to our hospital because of left upper quadrant pain. Contrast enhanced computed tomography showed a low density mass with delayed contrast effects as well as para-aortic node swelling with homogenous contrast effects. Histological examination of specimens obtained by endoscopic ultrasound fine needle aspiration revealed a pancreatic neuroendocrine tumor (NET) G2, according to the World Health Organization 2010 classification, and lymph node metastasis. Distal pancreatectomy and lymph node dissection were performed. On histological examination, the tumor showed well-differentiated morphology with an organoid pattern. The Ki67 labeling index was 21.6 %, and the mitotic count was 25/10 high power fields. As mentioned above, we made a final diagnosis of the lesion as "NET G3," because the tumor presented with well-differentiated morphology. Chemotherapy with Everolimus was administered. Liver metastasis occurred 11 months after the first operation, and a partial hepatectomy was performed. Histological findings were similar to those of the first operation. Herein we present a case of pancreatic well-differentiated neuroendocrine tumor with a high proliferative rate referred to as "NET G3," and review the relevant literature.
authors.affiliation: Department of Gastroenterology, Suzuka General Hospital, Mie, Japan. hiroki.tanaka@miekosei.or.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology, Suzuka General Hospital, Mie, Japan.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Matsusaki
authors.affiliation: Department of Pathology, Suzuka General Hospital, Mie, Japan.
authors.forename: Youichirou
authors.initials: Y
authors.lastname: Baba
authors.affiliation: Department of Gastroenterology, Suzuka General Hospital, Mie, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Isono
authors.affiliation: Department of Gastroenterology, Suzuka General Hospital, Mie, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kumazawa
authors.affiliation: Department of Gastroenterology, Suzuka General Hospital, Mie, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sase
authors.affiliation: Department of Gastroenterology, Suzuka General Hospital, Mie, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okano
authors.affiliation: Department of Gastroenterology, Suzuka General Hospital, Mie, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Saito
authors.affiliation: Department of Gastroenterology, Suzuka General Hospital, Mie, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Mukai
authors.affiliation: Department of Surgery, Suzuka General Hospital, 1275-53, Yamanohana, Yasuzuka, Suzuka-shi, Mie, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kaneko
mesh_terms: D000368:Aged; D049109:Cell Proliferation; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D006498:Hepatectomy; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008940:Mitotic Index; D018358:Neuroendocrine Tumors / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery
chemical_list: D019394:Ki-67 Antigen
keywords: EUS-FNA; NET G3; Neuroendocrine carcinoma; Neuroendocrine neoplasm; WHO 2010 classification