title: Metastatic VIPoma presenting as an ovarian mass.
abstract: BACKGROUND
  Pancreatic VIPomas are exceedingly rare, with an annual incidence of less than 1 per million. Most VIPomas are metastatic at diagnosis, with the liver being the most common site of spread.
  
  
  METHODS
  We describe a highly unusual case of a metastatic pancreatic VIPoma to an ovary in a 54 year-old patient. She was ten years out from her initial diagnosis when routine CT scan showed an enlarging left adnexal mass. After having both ovaries removed laparoscopically the final pathology was consistent with her pancreatic primary. To our knowledge, there has been only one other such case described in the literature.
  
  
  CONCLUSIONS
  In this case, pathology revealed metastatic neuroendocrine tumor involving both the left and right ovaries despite only the right ovary apparently enlarging. In our literature search, only two other cases of metastatic PNET to the ovaries have been reported. One case was a glucagonoma and the other a VIPoma. We recommend that clinicians consider referral of patients with metastatic NET and ovarian metastases to gynecologic surgery for consideration of surgical resection.
  
  
  CONCLUSIONS
  In conclusion, this case proves that although uncommon, PNET can show metastases in both ovaries even a decade after initial diagnosis.
authors.affiliation: University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL, USA.
authors.forename: Jaron
authors.initials: J
authors.lastname: Mark
authors.affiliation: H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bush
authors.affiliation: H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Evan
authors.initials: E
authors.lastname: Glazer
authors.affiliation: H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Strosberg
authors.affiliation: H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Ozlen
authors.initials: O
authors.lastname: Saglam
authors.affiliation: H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA. Electronic address: Sachin.Apte@moffitt.org.
authors.forename: Sachin M
authors.initials: SM
authors.lastname: Apte
keywords: Gynecologic neuroendocrine tumors; Neuroendocrine tumors; Ovarian cancer; PNET; Pancreatic cancer; VIPoma