An unusual presentation of “silent” disseminated pancreatic neuroendocrine tumor

摘要

To present a patient diagnosed with pancreatic carcinoidthat was extremely rare and produced an atypical carcinoidsyndrome. We reported a 58-year old male patient whopresented with long standing, prominent cervicallymphadenopathy and occasional watery diarrhea.Pathohistologicaf and immunohistochemical examinationof lymph node biopsy showed a metastatic neuroendocrinetumor, which was histological type A of carcinoid (EMA+,cytokeratin+, CEA-, NSE+, chromogranin A+, synaptophysin+,insulin-). Bone marrow biopsy showed identical findings.Primary site of the tumor was pancreas and diagnosis wasmade according to cytological and immunocytochemicalanalysis of the tumor cells obtained with aspiration biopsyof pancreatic mass (12 mm in diameter) under endoscopicultrasound guidance. However, serotonin levels in bloodand urine samples were normal. It is difficulty to establishthe precise diagnosis of a "functionally inactive" pancreaticcarcinoid and aspiration biopsy of pancreatic tumor underendoscopic ultrasound guidance can be used as a newpotent diagnostic tool.