Pancreatic neuroendocrine neoplasms coexisting with biliary intraductal papillary mucinous neoplasm: A case report and review of literature

Table 1 Laboratory test results

Item	Results	Reference range
Reference range	195.1 μmol/L	5.1-25.6 μmol/L
Direct bilirubin	178.0 μmol/L	1.78-6.8 μmol/L
Aspartate aminotransferase	175 U/L	0-40 U/L
Alanine aminotransferase	141 U/L	0-40 U/L
Carcinoembryonic antigen	1.82 ng/mL	< 5.2 ng/mL
Alpha-fetoprotein	2.43 ng/mL	0-7 ng/mL
Carbohydrate antigen 19-9	25.5 U/mL	0-34 ng/mL
Carbohydrate antigen 125	10.50 U/mL	0-35 ng/mL

Blood tests were taken upon admission.

Table 2 Literature review on pancreatic neuroendocrine tumors: Diagnosis, treatment, and clinical outcomes of key cases

Ref.	Case presentation	Diagnosis	Treatment	Outcome
Mihalache et al[41], 2019	18 patients with neuroendocrine pancreatic tumors, 11 insulinomas, 2 gastrinomas, 5 non-functioning tumors	CT, MRI, PET, and echo-endoscopic FNA	Surgical treatment 10 enucleations, 8 pancreatic resections, 2 splenectomies, and 1 liver metastasectomy	No local or distant recurrences except one case
Shiba et al[33], 2016	100 patients with pancreatic neuroendocrine neoplasms, 48 males, 52 females, median age: 55 years	CT, MRI, and PET	Surgical resection for NET G1/G2, varied treatments for NEC	5-year survival rates: 91% (NET G1), 69% (NET G2), and 10% (NEC)
Nappo et al[42], 2020	63-year-old man with a solid lesion of 7 cm diameter of the body-tail of the pancreas	PET, MRI, and echo-endoscopic FNA	Laparoscopic distal splenopancreatectomy and cholecystectomy	Final histopathology revealed micro-cystic serous cystadenoma
Chang et al[43], 2016	Four cases of intraductal PanNETs, 2 female, 2 male, aged 41-58 years	Light microscopy and immunohistochemistry	Not specified in detail	Not specified in detail
Ragni et al[44], 2021	59-year-old female with duodeno-cephalo-pancreasectomy for a well-differentiated pancreatic NEN, hepatic metastases, pituitary metastases	PET, MRI, and echo-endoscopic FNA	Surgical removal of pituitary lesion	Survival of 14 months post-surgery
In Park et al[36], 2023	Mixed neuroendocrine-non-neuroendocrine carcinoma in gallbladder with liver metastasis of neuroendocrine carcinoma	Tumor markers, MRI, and PET	Radical cholecystectomy and hepatectomy	The patientis currently undergoing regular follow-up after chemotherapy. There was no evidence of recurrence for 24 months from radicalcholecystectomy
Sacco Casamassima et al[39], 2016	19 patients ≤ 21 years with pancreatic neoplasms, median age: 16.6 years	CT, MRI, and echo-endoscopic FNA	Various surgeries	Most patients alive and disease-free at median follow-up of 5.7 years
Feola et al[34], 2022	148 sporadic GEP-NENs, 50% males, mean age: 58.3 years	Pathological classification	Not specified in detail	Various outcomes based on stage and grade of disease
Spaziani et al[38], 2023	71-year-old obese Caucasian male with incidental pancreatic lesion during follow-up for cutaneous melanoma	MRI, PET, EUS-FNB, and PET-CT	Surgery	Not specified in detail
Miric et al[46], 2016	59-year-old patient with non-functional well-differentiated pancreatic neuroendocrine tumor with liver and bone metastases	Abdominal ultrasound, CT, and MRI	Surgical excision of pancreatic tumor, somatostatin analogues, interferon therapy, radiotherapy	Good long-term survival, no local recurrence or new metastases after 3 years

CT: Computed tomography; MRI: Magnetic resonance imaging; PET: Positron emission tomography; FNA: Fine-needle aspiration; NET: Neuroendocrine tumor; NEC: Neuroendocrine carcinomas; PanNETs: Pancreatic neuroendocrine tumors; GEP: Gastroenteropancreatic; EUS-FNB: Endoscopic ultrasound-guided fine-needle biopsy.