A CASE OF MALIGNANT NONFUNCTIONING ISLET CELL TUMOR OF THE PANCREAS

Abstract

This is a report of a case of nonfunctioning islet cell carcinoma which occupied almost the entire upper abdomen in a 72-year-old female complaining of an upper abdominal tumor and epigastric pain. She had the tumor for 10 years and it's size increased slightly over the last three years. Enhanced CT pictures showed irregular tumor staining and a cystic pattern. An angiography revealed the hypervascular tumor. Serum levels of various endocrine hormones were within normal range. Therefore, the tumor was thought to be a nonfunctioning islet cell tumor of the pancreas. During surgery it was found that the tumor was located in the tail and body of the pancreas, and was 15×13×8.0 cm in size with macroscopic small metastatic lesions in the liver. Postoperative histopathological examination revealed malignancy with venous and lymphatic invasions.Nonfunctioning islet cell tumors are rare, have a high frequency of malignancy, but grow slowly, and the prognosis after surgical resection is generally good. In this case recurred liver metastasis could be detected by remarkable increase in serum neuron specific enolase which had been monitored after surgery, its availability as a tumor marker being suggested.Aiming at life-prolongation, intensive treatments including intra-arterial infusion chemotherapy and transhepatic arterial embolization are now in consideration.