すい原発ｎｅｕｒｏｅｎｄｏｃｒｉｎｅ　ｃｅｌｌ　ｃａｒｃｉｎｏｍａの１例

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  • A RESECTED CASE OF NEUROENDOCRINE CELL CARCINOMA OF THE PANCREAS.

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A 56-year-old man admitted to the hospital because of jaundice and fever was found to have a tumor 20 mm in diameter at the head and a tumor 25 mm in diameter at the uncus of the pancreas on an abdominal CT scan. Cholangiography visualized discontinuation of the end of common bile duct and dilatation of the main pancreatic duct. There was an ulcerative lesion beneath the ampulla of Vater, which was diagnosed as neuroendocrine cell carcinoma on a biopsy. A pylorus preserving pancreatoduodenectomy was performed. On the excised material, a 21×15 mm tumor in the upper part of the pancreatic head and another tumor in the uncus were noted. Histologically the most part of the tumor was present in the pancreatic tissue and the tumor in the pancreatic uncus was lymph node metastasis. Histopathologically it was TS2, nodular type, pT3 {pCH (+), pDU (+), pS (-), pRP (-), pPV (-), pA (-), pPL (-), pOO (-)}, pN3, sM0, and fStage IVb. On immunological stainings, the tumor was positive for all synaptophysin, chromogranin, and NSE. From these findings, neuroendocrine cell carcinoma arising in the pancreas was diagnosed. As of 5 months after the operation, the patient experienced paraarterial lymph nodes and pulmonary metastases and has been treated with chemotherapy.

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