A calcitonin-producing pancreatic neuroendocrine neoplasm treated with distal pancreatectomy a lengthy time after a left trisectionectomy for liver metastases: a case report

Surgical Case Reports

Case Report

Katsushi Yoshida¹  Masataka Ando¹  Ryuzo Yamaguchi¹  Kenji Kato¹  Ryusei Yamamoto¹  Yoshitaka Toyoda¹  Aya Tanaka¹ 

[1] Division of Surgery, Inazawa Municipal Hospital, 100 Nazukacho-Numa, 492-8510, Inazawa, Aichi, Japan;

关键词: Calcification;    Calcitonin;    Hepatectomy;    Neuroendocrine neoplasms;    Pancreatectomy;   

DOI  :  10.1186/s40792-022-01575-7

 received in 2022-10-13, accepted in 2022-11-28,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundCalcitonin-producing pancreatic neuroendocrine neoplasms (PanNENs) are extremely rare. There have been no reports of a patient in whom liver metastases were the presenting finding, and a calcitonin-producing PanNEN was subsequently detected after a lengthy period.Case presentationA 53-year-old man had diarrhea for several years. Computed tomography (CT) revealed multiple liver tumors. We performed a left trisectionectomy with a bile duct resection. The histologic examination showed neuroendocrine tumors G1. Immunohistochemistry was positive for calcitonin and the serum calcitonin level was elevated. Neuroendocrine neoplasms of hepatic origin are extremely rare, so a systemic exploration was performed, but no tumor was detected. CT showed a 4-mm calcification in the pancreatic body, but no contrast-enhanced mass was noted. Although the liver tumors were resected, the diarrhea and high serum calcitonin level persisted. Serial examinations were performed for 6 years, but no tumor was identified; however, 6.5 years after the hepatectomy the serum calcitonin level increased. CT showed a 10-mm contrast-enhanced mass in the calcified area of the pancreatic body. A distal pancreatectomy was performed. The histologic examination showed a neuroendocrine tumor G1, which mimicked the liver tumors. Immunohistochemistry was positive for calcitonin. After the distal pancreatectomy, the serum calcitonin level decreased and diarrhea resolved. The calcitonin-producing neuroendocrine neoplasm was considered the pancreatic primary and the hepatic tumors were metastases.ConclusionsCalcitonin-producing PanNENs may be initially recognized as liver tumors and may become evident after a lengthy period, thus long-term observation is recommended. Aggressive surgeries may contribute to long-term survival.

【 授权许可】

CC BY   
© The Author(s) 2022

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