Endocrine Abstracts

Pancreatic neuroendocrine tumors are rare neoplasms of this organ. The majority of them are tumors without hormonal activity. Approximately 35% of the pancreatic neuroendocrine tumors (pNETs) are functional, the most common of which is an insulinoma. We present a 57 year old lady with dyspepsia, nausea and Fe deficiency anaemia for more then a year. On examination had a epigastric mass, endoscopy was consistent with a well differentiated endocrine grade 2 tumor. Octeotide scan showed increased uptake. CT abdomen: large enhancing mass with calcification extending from pancreas to stomach, spleen and portal vein. Discussed with wessex carcinoid MDT. Underwent a left upper quadrant clearance: Total gastrectomy, distal oesophagectomy, pancreatectomy, spenectomy, Roux-en-y reconstruction, portal vein resection and anastomosis. Histology confirmed a well differentiated pancreatic endocrine carcinoma with nodal, vascular and perineural invasion, staging PT3N1R1 excision. Post operatively developed diabetes, hypo unawareness, and malnutrition, treated with insulin pump and dexcom G4 CGM and high dose creon. Timely and right intervention saved patients life. We would like to emphasize that in this case Octeotide imaging & contrast CT can be effectively helpful especially in conjunction with other useful diagnostic methods which are handled in pancreatic tumor’s. We put emphasis on corrected and extended histopathological report which determines further management according to prognostic and prediction factors of patients with neuroendocrine pancreatic tumor.