Year 2017 / Volume 109 / Number 9
Case Report
Synchronous intraductal papillary mucinous neoplasm and a pancreatic neuroendocrine tumor: more than a coincidence?

663-635

DOI: 10.17235/reed.2017.5003/2017

Juliana M. Costa, Sofia Carvalho, João B. Soares,

Abstract
Background: Although the association between intraductal papillary mucinous neoplasm of the pancreas (IPMN) and pancreatic neuroendocrine tumor (PNET) has been increasingly reported, whether this association is real or coincidence remains unclear. We report a case of synchronous IPMN and a PNET which were diagnosed preoperatively and discuss the tumorigenesis, clinicopathological features and management of these rare tumors based on the published literature. Case report: A 56-year-old male was incidentally diagnosed with a 14 mm branch duct IPMN and a 3.6 mm non-functional PNET during an evaluation due to persistent upper abdominal pain via endoscopic ultrasound. Close follow-up of the patient was decided as the IPMN had no worrisome features. A review of twenty-two previously reported cases of synchronous IPMN and PNET indicated that: a) only seven cases were diagnosed preoperatively; b) abdominal pain was the main presenting symptom; c) IPMN was the dominant tumor and presented with low grade dysplasia; d) the PNET was small and non-functional and had an indolent behavior; and e) only one case underwent radiologic follow-up. Discussion: IPMN are associated with other pancreatic and extrapancreatic malignancies. Thus, the entire pancreatic parenchyma should be examined closely during the evaluation of an IPMN in order to exclude other pancreatic lesions, for example, a PNET.
Share Button
New comment
Comments
No comments for this article
References
1. Gill KR, Scimeca D, Stauffer J, Krishna M, Woodward TA, Jamil LH, et al. Pancreatic Neuroendocrine Tumors among Patients with Intraductal Papillary Mucinous Neoplasms: Real Association or Just a Coincidence? JOP 2009; 10(5): 515-7.
2. Kadota Y, Shinoda M, Tanab M, Tsujikawa H, Ueno A, Masugi Y, et al. Concomitant pancreatic endocrine neoplasm and intraductal papillary mucinous neoplasm: a case report and literature review. World J Surg Oncol 2013 [Online, 21 March 2013]; [11:75]. DOI: 10.1186/1477-7819-11-75.
3. Goh BK, Ooi LL, Kumarasinghe MP, Tan YM, Peng-Cheow C, Chow PK, et al. Clinicopathological features of patients with concomitant intraductal papillary mucinous neoplasm of the pancreas and pancreatic endocrine neoplasm. Pancreatology 2006; 6: 520-526.
4. Marrache F, Cazals-Hatem D, Kianmanesh R, Palazzo L, Couvelard A, O'Toole D, et al. Endocrine tumor and intraductal papillary mucinous neoplasm of the pancreas: a fortuitous association? Pancreas 2005; 31(1): 79–83.
5. Stukavec J, Jirasek T, Mandys V, Denemark L, Havluj L, Sosna B, et al. Poorly differentiated endocrine carcinoma and intraductal papillary-mucinous neoplasm of the pancreas: Description of an unusual case. Pathol Res Pract 2007; 203(12): 879–884.
6. Larghi A, Stobinski M, Galasso D, Lecca PG, Costamagna G. Concomitant intraductal papillary mucinous neoplasm and pancreatic endocrine tumour: Report of two cases and review of the literature. Dig Liver Dis 2009; 41: 759–761.
7. Ishizu S, Setoyama T, Ueo T, Ueda Y, Kodama Y, Ida H, et al. Concomitant Case of Intraductal Papillary Mucinous Neoplasm of the Pancreas and Functioning Pancreatic Neuroendocrine Tumor (Vasoactive Intestinal Polypeptide-Producing Tumor) First Report. Pancreas 2016; 45(6): e24-25.
8. Jiao Y, Shi C, Edil BH, de Wilde RF, Klimstra DS, Maitra A, et al. DAXX/ATRX, MEN1, and mTOR pathway genes are frequently altered in pancreatic neuroendocrine tumors. Science 2011; 331(6021): 1199–1203.
9. Rosenberg AM, Friedmann P, Del Rivero J, Libutti SK, Laird AM. Resection versus expectant management of small incidentally discovered nonfunctional pancreatic neuroendocrine tumors. Surgery 2016; 159(1): 302-309.
10. Del Chiaro M, Verbeke C, Salvia R, Klöppel G, Werner J, McKay C, et al. European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis 2013; 45(9): 703-711.
Related articles

Letter

Duodenal lymphangiomas: endoscopic ultrasound features

DOI: 10.17235/reed.2024.10338/2024

Digestive Diseases Image

Imaging of pancreatic desmoid fibromatosis by endoscopic ultrasound

DOI: 10.17235/reed.2023.9792/2023

Digestive Diseases Image

Endosonographic and ERCP findings in COVID-19 critical illness cholangiopathy

DOI: 10.17235/reed.2022.9218/2022

Letter

Angiosarcoma of the aorta diagnosed via endoscopic ultrasound

DOI: 10.17235/reed.2022.8879/2022

Digestive Diseases Image

Pancreatic lymphoma during pregnancy

DOI: 10.17235/reed.2022.8811/2022

Digestive Diseases Image

When needles are not enough, forceps delivers!

DOI: 10.17235/reed.2022.8697/2022

Letter

Lumen-apposing metal stent deployment failure

DOI: 10.17235/reed.2020.7060/2020

Letter

Sometimes things are what they seem

DOI: 10.17235/reed.2019.5911/2018

Letter

A giant abdominal collection: when things are not what they seem

DOI: 10.17235/reed.2018.5642/2018

Letter to the Editor

Author´s reply: Cystic pancreatic neuroendocrine tumors. A diagnostic challenge

DOI: 10.17235/reed.2018.5415/2017

Letter to the Editor

Late migration of a metal stent after EUS-drainage of a pancreatic pseudocyst abscess

DOI: 10.17235/reed.2018.5411/2017

Letter to the Editor

EUS-guided ethanol ablation therapy for gastric stromal tumors

DOI: 10.17235/reed.2017.5361/2017

Letter to the Editor

Neuroendocrine tumors of the pancreas: keys issues in dealing with heterogeneity

DOI: 10.17235/reed.2017.4997/2017

Letter to the Editor

A rectal neuroendocrine neoplasm

DOI: 10.17235/reed.2017.4836/2017

Letter to the Editor

Pancreatic neuroendocrine tumors

DOI: 10.17235/reed.2017.4725/2016

Review

Endoscopic ampullectomy: a technical review

DOI: 10.17235/reed.2016.3867/2015

Case Report

Pelvic inflammatory myofibroblastic tumor mimicking a rectal cancer

DOI: 10.17235/reed.2015.3777/2015

Citation tools
Costa J, Carvalho S, Soares J. Synchronous intraductal papillary mucinous neoplasm and a pancreatic neuroendocrine tumor: more than a coincidence? . 5003/2017


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1123 visits.
This article has been downloaded 165 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 10/04/2017

Accepted: 17/05/2017

Online First: 14/07/2017

Published: 31/08/2017

Article revision time: 35 days

Article Online First time: 95 days

Article editing time: 143 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology