Bassoff Logan, Kersey Kenneth, Debus Ian, Glotzer Daniel
Clinical Sciences, Florida State University College of Medicine, Tallahassee, USA.
Medicine, Florida State University College of Medicine, Tallahassee, USA.
Cureus. 2025 Aug 2;17(8):e89256. doi: 10.7759/cureus.89256. eCollection 2025 Aug.
Pancreatic neuroendocrine tumors (PNETs) are rare pancreatic neoplasms that can be classified as functioning or non-functioning. Non-functioning PNETs are often asymptomatic and detected incidentally. We discuss the case of a 54-year-old female with a past medical history significant for Crohn's disease (CD) who underwent a CT enterography in 2022 for follow-up imaging. At that time, a lesion at the pancreatic tail was discovered, and active surveillance was chosen. Two years later, an ER visit for symptomatic cholelithiasis indicated growth of this lesion via MRI and CT. A subsequent biopsy confirmed a well-differentiated grade 1 non-functioning PNET and accompanying pancreatic cyst. Surgical options were discussed, and the patient underwent distal pancreatectomy with splenectomy, and the tumor was successfully excised. The patient had an uneventful post-surgical course. Non-functioning PNETs are challenging to diagnose due to their subtle symptoms and are often detected at later stages. Imaging modalities like MRI, CT, and endoscopic ultrasound are key in diagnosis. Surgical resection remains the most definitive treatment modality. This report highlights the diagnostic complexity and the potential for varied presentations of non-functioning PNETs, underscoring the need for further research on their characteristics, management, and associations with other pancreatic lesions.
胰腺神经内分泌肿瘤（PNETs）是一种罕见的胰腺肿瘤，可分为功能性或非功能性。非功能性PNETs通常无症状，多为偶然发现。我们讨论了一例54岁女性患者的病例，该患者有克罗恩病（CD）病史，2022年因随访成像接受了CT小肠造影。当时，在胰尾发现了一个病变，并选择了积极监测。两年后，因有症状的胆结石到急诊就诊，通过MRI和CT检查显示该病变有生长。随后的活检证实为高分化1级非功能性PNET，并伴有胰腺囊肿。讨论了手术方案，患者接受了胰体尾切除术加脾切除术，肿瘤被成功切除。患者术后恢复顺利。非功能性PNETs因其症状不明显而难以诊断，且常于疾病后期才被发现。MRI、CT和内镜超声等成像方式是诊断的关键。手术切除仍然是最确切的治疗方式。本报告强调了非功能性PNETs诊断的复杂性以及其表现的多样性，凸显了对其特征、管理以及与其他胰腺病变关联进行进一步研究的必要性。
