Jukemura José, Montagnini André Luis, Perini Marcos Vinícius, de Almeida José Luiz Jesus, Rodrigues Joaquim José Gama, da Cunha José Eduardo Monteiro
Department of Gastroenterology, University of São Paulo, School of Medicine. São Paulo, Brazil.
JOP. 2006 Jan 11;7(1):56-61.
Endocrine tumors are a less commonly known cause of acute pancreatitis. This report presents the case of a patient who have had acute pancreatitis secondary to a pancreatic endocrine neoplasm. The majority of the cases previously reported were non-functioning tumors and the pancreatitis tended to be mild. Moreover, the majority of the tumors were diagnosed in advanced stages, hindering curative treatment.
A 31-year-old female patient presented with epigastric pain and a history of recurrent acute pancreatitis. Preoperative imaging investigation showed a dilation of the distal portion of the main pancreatic duct and intra-operative ultrasound demonstrated a mild stricture of the main pancreatic duct at the body of the pancreas. Frozen-section examination revealed a malignant neoplasm, subsequently identified as a neuroendocrine carcinoma, and a distal pancreatectomy with splenectomy was performed. Acute pancreatitis was an early symptom in this patient who underwent a hopefully curative resection.
The authors conclude that, in patients with acute pancreatitis of unknown origin, the possibility of a non-functioning neuroendocrine tumor should be investigated.
内分泌肿瘤是急性胰腺炎鲜为人知的病因。本报告介绍了一例继发于胰腺内分泌肿瘤的急性胰腺炎患者。此前报道的大多数病例为无功能性肿瘤，胰腺炎往往较轻。此外，大多数肿瘤在晚期才被诊断出来，妨碍了根治性治疗。
一名31岁女性患者出现上腹部疼痛，并伴有复发性急性胰腺炎病史。术前影像学检查显示主胰管远端扩张，术中超声显示胰腺体部主胰管轻度狭窄。冰冻切片检查发现恶性肿瘤，随后确诊为神经内分泌癌，并进行了胰体尾切除术和脾切除术。急性胰腺炎是该患者接受有望根治性切除手术的早期症状。
作者得出结论，对于病因不明的急性胰腺炎患者，应调查无功能性神经内分泌肿瘤的可能性。
