Tewari Mallika, Patne Shashikant, Katiyar Richa, Biswas Dipanjan, Shukla H S
Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, 221005, Varanasi, UP India.
Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP India.
Indian J Surg. 2017 Oct;79(5):455-457. doi: 10.1007/s12262-017-1593-3. Epub 2017 Jan 18.
Diffuse serous cystic neoplasm (SCN) associated with pancreatic neuroendocrine tumor (PNET) is a rare finding reported previously in only three patients to the best of our knowledge. We herein present one such interesting report of a diffuse serous cystic adenoma (SCA) and co-existent PNET in a 25-year old lady who presented with abdominal pain for past 6 months. A triple-phase pancreatic protocol computed tomography (CT) scan revealed multiple cysts involving the entire pancreas. The cysts were thin walled, ranging from 2 to 8 cm in width, with no calcification or central scar that was confirmed at laparotomy. A frozen section revealed a neuroendocrine tumor and she underwent total pancreatectomy. Diffuse SCA with co-existent PNET infiltrating nerve bundles of the pancreatic parenchyma was made upon histopathology further verified by chromogranin-A immunostaining. The patient is insulin dependent and doing well at 2 years of follow-up. The origin of endocrine tumors from multipotent ductular stem cells has been suggested.
据我们所知，弥漫性浆液性囊性肿瘤（SCN）合并胰腺神经内分泌肿瘤（PNET）是一种罕见的发现，此前仅在三名患者中报道过。我们在此报告一例有趣的病例，一名25岁女性因腹痛6个月就诊，诊断为弥漫性浆液性囊腺瘤（SCA）并存PNET。胰腺三期增强计算机断层扫描（CT）显示整个胰腺有多个囊肿。囊肿壁薄，宽度为2至8厘米，无钙化或中心瘢痕，剖腹手术证实了这一点。冰冻切片显示为神经内分泌肿瘤，患者接受了全胰切除术。组织病理学检查发现弥漫性SCA并存PNET浸润胰腺实质的神经束，嗜铬粒蛋白A免疫染色进一步证实了这一点。患者依赖胰岛素，随访2年情况良好。有观点认为内分泌肿瘤起源于多能导管干细胞。
