Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 7, 2012; 18(45): 6682-6685
Published online Dec 7, 2012. doi: 10.3748/wjg.v18.i45.6682
Neuroendocrine carcinoma of the pancreas with soft tissue metastasis
Jie Chen, Qi Zheng, Zhe Yang, Xin-Yu Huang, Zhou Yuan, Juan Tang
Jie Chen, Qi Zheng, Zhe Yang, Xin-Yu Huang, Zhou Yuan, Department of Surgery, Shanghai 6th People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China
Juan Tang, Department of Pathology, Shanghai 6th People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China
Author contributions: Zheng Q designed the research; Chen J and Tang J dealt with the figures; Huang XY and Yang Z performed the operation; Yuan Z and Chen J wrote the paper.
Correspondence to: Dr. Qi Zheng, PhD, Department of Surgery, Shanghai 6th People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China. jiephd1983@126.com
Telephone: +86-21-64369181 Fax: +86-21-64367326
Received: August 17, 2012
Revised: October 26, 2012
Accepted: October 30, 2012
Published online: December 7, 2012
Abstract

Neuroendocrine carcinoma (NEC) of the pancreas is rare. We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis. The patient presented with right upper abdominal discomfort. Computed tomography revealed a low-density heterogeneous mass in the tail and body of the pancreas that encroached on the greater curvature of the stomach and spleen. We performed exploratory laparotomy and total pancreatectomy with splenectomy and total gastrectomy. Histopathological analysis showed spindle-shaped cells with scanty cytoplasm and hyperchromatic nuclei, confirming a primary pancreatic NEC. One month after the surgery, the patient experienced leg swelling. Positron emission tomography-computed tomography revealed high uptake of fludeoxyglucose in the left leg, and the leg was amputated. Histopathological analysis confirmed metastasis of pancreatic NEC. The patient was followed up and received chemotherapy (etoposide and cisplatin). One month after amputation, the level of tumor marker neuron-specific enolase was 142.70 μg/L and computed tomography scan revealed an aggravated metastatic lesion. The patient suffered from unbearable pain and we treated him with odynolysis. Four months postoperatively, the patient died of respiratory failure.

Keywords: Neuroendocrine carcinoma; Pancreas; Soft tissue metastasis; Neuron-specific enolase; Positron emission tomography-computed tomography