Pancreatic Collision Tumor of Ductal Adenocarcinoma and Neuroendocrine Tumor

Wang, Yuchen; Gandhi, Seema; Basu, Anupam; Ijeli, Anthonia; Kovarik, Paula; Sekosan, Marin; Demetria, Melchor

doi:10.14309/crj.2018.39

Cited by 12 publications

(18 citation statements)

References 17 publications

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“…Gross pathologic examination revealed neuroendocrine cells with ductal carcinoma without a transition zone. [ 7 ] In the present case, the PDAC and NET were not collision tumors; they were discontinuous and independent of each other. We did not observe the NET in the tail of the pancreas preoperatively because it was too small to be found on CT or MRI, and the patient had no symptoms of hormone production such as hypoglycemia, gastrointestinal ulceration, or diarrhea.…”

Section: Discussionmentioning

confidence: 51%

“…Only 2 reported cases of collision tumors involved a PDAC and a NET. [ 6 , 7 ] In one case, the preoperative diagnosis was a main-duct IPMN. The pathologic examination revealed a PDAC involving the whole pancreas and a NET located in the head of the pancreas.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] Additionally, the combination of PDAC and NET is extremely rare. [ 6 , 7 ] We herein report a highly unusual case of the coexistence of a PDAC, pseudocyst, and NET, showing a “side-by-side pattern.”…”

Section: Introductionmentioning

confidence: 98%

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Concurrent ductal adenocarcinoma, pseudocyst, and neuroendocrine tumor of the pancreas

Liu

Wang

et al. 2020

Medicine

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Introduction: Pancreatic pseudocyst is one of the most common cystic lesions. It always occurs following pancreatitis and is rarely found in combination with pancreatic adenocarcinoma. The coexistence of exocrine and neuroendocrine tumors of the pancreas is also infrequent. We herein report a case of simultaneous occurrence of a pancreatic ductal adenocarcinoma (PDAC), pseudocyst, and neuroendocrine tumor (NET), showing a “side-by-side pattern.” Patient concern: A 74-year-old man was hospitalized for epigastric pain and poor appetite. He had no history of pancreatitis, alcohol consumption, or smoking. Diagnosis and intervention: Abdominal enhanced computed tomography and magnetic resonance imaging revealed a 15 × 8 cm cystic lesion with poor enhancement located in the tail of the pancreas. The distal aspect of the main pancreatic duct was dilated. The pancreatic parenchyma adjacent to the cystic lesion showed slightly heterogeneous enhancement on computed tomography and magnetic resonance imaging. Laboratory examination showed an elevated carbohydrate antigen 19–9 serum level. The patient was preoperatively diagnosed with intraductal papillary mucinous neoplasm and subsequently underwent laparotomy. During the operation, a hard white tumor measuring about 4 × 3 cm was palpated adjacent to the cystic lesion on the duodenal side, and a 0.6-cm nodule was simultaneously found in the pancreatic tail. Therefore, total pancreatectomy and splenectomy were performed. Histopathological examination showed that the tumor was PDAC with an adjacent pseudocyst, and the small nodule was suggestive of a NET. Outcomes: The patient survived without recurrence or metastasis in the follow-up visit 10 months after the operation and adjuvant chemotherapy. Conclusions: The concomitant occurrence of a PDAC, pseudocyst, and NET has not been previously reported. We suggest that if a pancreatic cyst is found, the coincidental occurrence of a malignant tumor should be considered, especially if the carbohydrate antigen 19–9 level is increased. Additionally, dilation of the pancreatic duct may be a diagnostic clue. Furthermore, the simultaneous occurrence of pancreatic endocrine and exocrine tumors is very uncommon. Preoperative diagnosis becomes difficult because of the lack of specific symptoms and radiological features.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

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Concurrent ductal adenocarcinoma, pseudocyst, and neuroendocrine tumor of the pancreas

Liu

Wang

et al. 2020

Medicine

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“…6 Pancreatic collision tumors composed of both a neuroendocrine tumor and a ductal adenocarcinoma has been reported. 21,22 However, to our knowledge, there is no reported case of a collision tumor of UCOGC with pancreatic NEN. Because we do not have a surgical biopsy or resection specimen to determine the transitional area or stroma between the two components, a collision tumor of UCOGC with pancreatic NEN cannot be ruled out.…”

Section: Table 1 Histological and Immunohistochemical Patterns On Thmentioning

confidence: 90%

A pancreatic mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) (NET and undifferentiated carcinoma of the pancreas with osteoclast-like giant cells) with metastatic neuroendocrine component to the liver

Gao¹,

Qorbani²,

Zhou³

2021

Autops Case Rep

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“…These neoplasms are composed of ductal adenocarcinoma associated with NEC ( Figure 6), although rare cases in which the neuroendocrine component was composed of a NET have been described. [51][52][53] However, they morphologically resemble collision tumours rather than true MiNENs, and their monoclonal origin has never been demonstrated. The two components of mixed ductal-neuroendocrine carcinoma are frequently intermingled, but sometimes they are more clearly separated.…”

Section: P a N C R E A Smentioning

confidence: 99%

Looking into digestive mixed neuroendocrine – nonneuroendocrine neoplasms: subtypes, prognosis, and predictive factors

Uccella

Rosa

2020

Histopathology

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Looking into digestive mixed neuroendocrinenonneuroendocrine neoplasms: subtypes, prognosis, and predictive factors Mixed neuroendocrinenonneuroendocrine neoplasms (MiNENs) of the digestive system represent a challenge for both pathologists and clinicians. Their nomenclature has changed several times, and their diagnostic criteria, classification and clinical behaviour have been matter of debate over the years. Although several attempts have been made to elucidate the pathogenesis and biology of MiNENs, some issues remain open. This review will provide: a historical background that helps in understanding the evolution of the concept and nomenclature of mixed neoplasms; a revision of the knowledge on this topic, including molecular aspects, to give the reader a comprehensive and practical overview on this challenging field of pathology; a focus on the diagnostic criteria and on the determination of prognostic and predictive factors; and a description of the different tumour types in the different sites of origin.

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Pancreatic Collision Tumor of Ductal Adenocarcinoma and Neuroendocrine Tumor

Cited by 12 publications

References 17 publications

Concurrent ductal adenocarcinoma, pseudocyst, and neuroendocrine tumor of the pancreas

Concurrent ductal adenocarcinoma, pseudocyst, and neuroendocrine tumor of the pancreas

A pancreatic mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) (NET and undifferentiated carcinoma of the pancreas with osteoclast-like giant cells) with metastatic neuroendocrine component to the liver

Looking into digestive mixed neuroendocrine – nonneuroendocrine neoplasms: subtypes, prognosis, and predictive factors

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