Abstract
A 54-year-old man with pancreatic head tumor had undergone pancreaticoduodenectomy and was diagnosed with pancreatic neuroendocrine tumor (P-NET) associated with sporadic multiple endocrine neoplasm type 1. Five years after the resection, P-NET recurred and liver metastases were observed. He was treated with a somatostatin analog. Eleven years after the resection, computed tomography revealed a new pancreatic hypodense and hypovascular mass adjacent to the P-NET that was diagnosed as pancreatic adenocarcinoma via endoscopic ultrasound-guided fine-needle aspiration. He underwent a total remnant pancreatectomy. Pathological examination showed that the lesion was constituted by a pancreatic ductal adenocarcinoma (PDAC) and a neuroendocrine tumor. Additionally, the invasive ductal carcinoma collided with the neuroendocrine tumor. Both PDAC and P-NET cells were observed in the collision area. We could observe the onset of PDAC during the treatment of P-NET. Moreover, we are the first to report the case of a collision of pancreatic endocrine and exocrine tumors diagnosed preoperatively.
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Akihisa Ohno, Nao Fujimori, Masami Miki, Takamasa Oono, Hisato Igarashi, Ryota Matsuda, Yutaka Koga, Yoshinao Oda, Takao Ohtsuka, Masafumi Nakamura, Tetsuhide Ito and Yoshihiro Ogawa declare that they have no conflict of interest.
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Ohno, A., Fujimori, N., Miki, M. et al. Collision of a pancreatic ductal adenocarcinoma and a pancreatic neuroendocrine tumor associated with multiple endocrine neoplasm type 1. Clin J Gastroenterol 14, 358–363 (2021). https://doi.org/10.1007/s12328-020-01234-0
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DOI: https://doi.org/10.1007/s12328-020-01234-0