Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2015; 21(33): 9822-9826
Published online Sep 7, 2015. doi: 10.3748/wjg.v21.i33.9822
Cutaneous metastasis as an initial presentation of a non-functioning pancreatic neuroendocrine tumor
Woo Young Shin, Keon Young Lee, Seung Ik Ahn, Shin-Young Park, Keun-Myoung Park
Woo Young Shin, Keon Young Lee, Seung Ik Ahn, Shin-Young Park, Keun-Myoung Park, Department of Surgery, Inha University Hospital, Inha University College of Medicine, Incheon 400-711, South Korea
Author contributions: Shin WY, Lee KY, Ahn SI and Park KM participated in the study design and performance; Park SY collected the clinical data.
Institutional review board statement: This study was reviewed and approved as an exemption by the Inha University Hospital Institutional Review Board.
Informed consent statement: The study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no potential conflicts of interest in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Woo Young Shin, MD, Assistant Professor, Department of Surgery, Inha University Hospital, Inha University College of Medicine, 27 Inhang-Ro, Jung-Gu, Incheon 400-711, South Korea. mesik@daum.net
Telephone: +82-32-8903590 Fax: +82-32-8903549
Received: April 21, 2015
Peer-review started: April 23, 2015
First decision: May 18, 2015
Revised: May 26, 2015
Accepted: July 8, 2015
Article in press: July 8, 2015
Published online: September 7, 2015
Processing time: 138 Days and 19.5 Hours
Abstract

Non-functioning pancreatic neuroendocrine tumors (NF-PNETs) are rare tumors that account for 2% of all pancreatic malignancy. About 60% of NF-PNETs present distant metastases and usually hepatic metastases. However, cutaneous metastases are very rare. Herein, we report our experience with a 60-year-old male who visited our outpatient clinic with a mass on his left hip. An abdominal computerized tomography scan demonstrated not only a left hip mass and an enlarged left inguinal lymph node, but also a huge heterogeneous enhancing mass on the pancreas. Initially, we removed the metastatic lesions, which was a small cell neuroendocrine carcinoma with 50% of the Ki-67 index in the histopathological report. After 3 wk, we performed a total pancreatectomy and a total gastrectomy. Four weeks after the 1st operation, we detected a recurrence at the operative bed on his left hip, and subsequently removed the recurring mass. The patient was receiving chemotherapy based on etoposide and cisplatin treatment.

Keywords: Pancreas; Neuroendocrine tumor; Skin neoplasm; Neoplasm metastasis; Pancreatectomy

Core tip: We report the first known case of cutaneous metastasis as an initial presentation of a high grade non-functional pancreatic neuroendocrine tumor treated by surgical resection of both primary and metastatic lesions.