J Korean Soc Magn Reson Med.  2010 Dec;14(2):145-150. 10.13104/jksmrm.2010.14.2.145.

Non-Functioning, Malignant Pancreatic Neuroendocrine Tumor in a 16-Year-old Boy: A Case Report

• Lim SW
• Lee YH
• Choi SS
• Cho HS

• KMID: 2206913
• DOI: http://doi.org/10.13104/jksmrm.2010.14.2.145

Abstract

We report the case of a 16-year-old boy with a solid pancreatic mass which proved to be a nonfunctioning, malignant pancreatic neuroendocrine tumor (PNET). In pediatric patients, malignant pancreatic tumors are rare, especially malignant PNET. When dynamic contrast enhanced MRI showed a well enhancing solid pancreatic tumor on arterial and delayed phases and combined with malignant features, such as vascular invasion, invasion of adjascent organs, and lymphadenopathy, we should include malignant pancreatic neuroendocrine tumor in the differential diagnosis of childhood pancreatic tumors.

Keyword

Pancreatic neuroendocrine tumor; Islet cell tumor; Children; Magnetic resonance (MR)

MeSH Terms

Adenoma, Islet Cell
Adolescent
Child
Diagnosis, Differential
Humans
Lymphatic Diseases
Neuroectodermal Tumors, Primitive
Neuroendocrine Tumors

Figure

• 

  Fig. 1 A 16-year-old boy with epigastric pain for one year. (a) Ccontrast-enhanced CT of the abdomen showed a multilobulated contoured solid mass with inhomogeneous enhancement in the region of the pancreatic head (arrows). (b) The axial T2-weighted MR image obtained at the same level as in A, depicts a multilobulated mass with heterogeneous high signal intensity. (c) The mass showed intermediate to low signal intensity on the axial T1-weighted MR image. (d) The mass revealed a reticular pattern of inhomogeneous enhancement on the late portal phase of dynamic gadolinium-enhanced T1-weighted MR image. (e) On the delayed phase of dynamic gadolinium-enhanced T1-weighted MR image, persistent and intense enhancement of the mass and multiple conglomerated metastatic lymphadenopathy were seen (arrow). (f) MRCP showed that despite the large size of the mass, the common bile duct (arrow) was not dilated but had been displaced by the mass. (g) The coronal T1-weighted MR image showed encasement of the main portal vein (arrow) by the mass, which suggested the malignant features of the mass. (h) Photomicrograph (H & E,×400 ) of the specimen showed that the tumor cells had a trabacular pattern over the fibrotic and hyaline stroma. (i) The immunohistochemistry staining for synaptophysin (×100) was positive which confirmed the diagnosis of malignant endocrine neoplasm of the pancreas.

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