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Tumore cistico pancreatico trattato mediante splenopancreasectomia distale con riscontro occasionale di neoplasia neuroendocrina

Pala, Carlo and Serventi, Fernando and Scognamillo, Fabrizio and Attene, Federico and Pisano, Ilia Patrizio and Cugia, Luigi and Meloni, Mario and Trignano, Mario (2008) Tumore cistico pancreatico trattato mediante splenopancreasectomia distale con riscontro occasionale di neoplasia neuroendocrina. Annali italiani di chirurgia, Vol. 79 (6), p. 451-456. ISSN 0003-469X. Article.

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Abstract

INTRODUCTION: Cystic and neuroendocrine pancreatic neoplasms are quite rare tumors which diagnosis is often difficult due to their non specific symptomatology and limited diagnostic accuracy of conventional diagnostic instruments. Their treatment is still controversial.
CASE REPORT: A young woman is admitted with abdominal pain and dyspepsia. Instrumental diagnosis reveals a cystic pancreatic lesion which seems to be malignant as CEA of pancreatic liquid is increased. The patient undergoes distal spleno-pancreatectomy and postoperative histological examination found IPMN associated with MCN and furthermore there was occasional diagnosis of a small neuroendocrine tumor in the pancreatic tail.
DISCUSSION: A correct diagnostic approach is indispensable for a correct therapeutic approach. Radical surgical treatment is indicated in all cases of main- and branch duct IPMN and in case of MCN with signs of malignant transformation. Surgical treatment is also the gold standard for pancreatic neuroendocrine tumors if they are singular and in M0 stage.
CONCLUSIONS: In case of cystic and neuroendocrine neoplasms of the pancreas the preoperative diagnostic approach is often not enough to obtain a definite diagnosis. Review of literature and this case report show that a definite diagnosis can only be done after postoperative histological examination. Recent prospective studies suggest the possibility for a follow up instead of surgical treatment for some neuroendocrine tumors.

Item Type:Article
ID Code:4778
Status:Published
Refereed:Yes
Uncontrolled Keywords:Pancreas, cystic pancreatic tumor, IPMN, MNC, neuroendocrine tumor
Subjects:Area 06 - Scienze mediche > MED/18 Chirurgia generale
Divisions:001 Università di Sassari > 03 Istituti > Patologia speciale medica e metodologia clinica
Publisher:Edizioni Luigi Pozzi
ISSN:0003-469X
Deposited On:09 Nov 2010 09:19

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