Concurrent ductal adenocarcinoma, pseudocyst, and neuroendocrine tumor of the pancreas: A case report.

摘要: INTRODUCTION Pancreatic pseudocyst is one of the most common cystic lesions. It always occurs following pancreatitis and rarely found in combination with pancreatic adenocarcinoma. The coexistence exocrine neuroendocrine tumors pancreas also infrequent. We herein report a case simultaneous occurrence ductal adenocarcinoma (PDAC), pseudocyst, tumor (NET), showing "side-by-side pattern." PATIENT CONCERN A 74-year-old man was hospitalized for epigastric pain poor appetite. He had no history pancreatitis, alcohol consumption, or smoking. DIAGNOSIS AND INTERVENTION Abdominal enhanced computed tomography magnetic resonance imaging revealed 15 × 8 cm lesion enhancement located tail pancreas. distal aspect main duct dilated. parenchyma adjacent to showed slightly heterogeneous on imaging. Laboratory examination an elevated carbohydrate antigen 19-9 serum level. patient preoperatively diagnosed intraductal papillary mucinous neoplasm subsequently underwent laparotomy. During operation, hard white measuring about 4 × 3 cm palpated duodenal side, 0.6-cm nodule simultaneously tail. Therefore, total pancreatectomy splenectomy were performed. Histopathological that PDAC small suggestive NET. OUTCOMES survived without recurrence metastasis follow-up visit 10 months after operation adjuvant chemotherapy. CONCLUSIONS concomitant PDAC, NET has not been previously reported. suggest if cyst found, coincidental malignant should be considered, especially level increased. Additionally, dilation may diagnostic clue. Furthermore, endocrine very uncommon. Preoperative diagnosis becomes difficult because lack specific symptoms radiological features.