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Revista cubana de medicina militar
By Alberto Suárez Cuevas, Anet Córdova Martínez and Rafael Isaías Reyes Velázquez.
Pancreatic neuroendocrine tumors (pNETs) represent about 1-2% of all pancreatic neoplasms, are infrequent and can present with nonspecific symptoms, making early diagnosis difficult.
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To describe the diagnostic approach and management of an atypical form of a rare tumor in a patient with chronic nonspecific abdominal symptoms. Clinical Case: A 60-year-old female with hypertension consulted for diffuse abdominal pain of one year duration. Abdominal computed tomography revealed an extensive lesion in the body and tail of the pancreas with involvement of the splenic artery. Distal pancreatectomy with splenectomy was performed, preserving the pancreatic head and uncinate process. Histopathological examination reported a well-differentiated neuroendocrine tumor (Grade G1), measuring 10 × 9 × 4 cm, with cystic degeneration, hemorrhage, necrosis, osseous metaplasia, and calcifications. The Ki-67 index was < 2%, with 0/10 lymph nodes positive. Immunohistochemistry was positive for chromogranin and synaptophysin.
This case illustrates the importance of considering PNETs in the differential diagnosis of pancreatic masses, even in the absence of evident hormonal syndrome. Radical surgery enables both treatment and definitive diagnosis, which are essential for guiding follow-up.
Published in Revista cubana de medicina militar. The abstract is shown as published and remains the work of its authors; read the full article at the source.
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