Ogawa M, Kawaguchi Y, Maruno A, Ito H, Nakagohri T, Hirabayashi K, Yamamuro H, Yamashita T, Mine T. Small serotonin-positive pancreatic endocrine tumors caused obstruction of the main pancreatic duct. World J Gastroenterol 2012; 18(45): 6669-6673 [PMID: 23236243 DOI: 10.3748/wjg.v18.i45.6669]
Corresponding Author of This Article
Masami Ogawa, MD, Department of Gastroenterology, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan. ma_ogawa@tokai-u.jp
Article-Type of This Article
Case Report
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Masami Ogawa, Yoshiaki Kawaguchi, Atsuko Maruno, Hiroyuki Ito, Tetsuya Mine, Department of Gastroenterology, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan
Toshio Nakagohri, Department of Gastroenterological Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan
Kenichi Hirabayashi, Department of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan
Hiroshi Yamamuro, Tomohiro Yamashita, Department of Radiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan
Author contributions: Ogawa M and Kawaguchi Y designed the report; Ogawa M, Kawaguchi Y, Maruno A and Ito H were attending doctors for the patients; Nakagohri T performed surgical operation; Hirabayashi K performed pathological examinations; Yamamuro H and Yamashita T performed image diagnosis; Mine T organized the report; and Ogawa M wrote the paper.
Correspondence to: Masami Ogawa, MD, Department of Gastroenterology, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan. ma_ogawa@tokai-u.jp
Telephone: +81-463-931121 Fax: +81-463-937134
Received: May 22, 2012 Revised: August 1, 2012 Accepted: August 3, 2012 Published online: December 7, 2012
Abstract
We report 2 cases of pancreatic endocrine tumors that caused obstruction of the main pancreatic duct (MPD). A 49-year-old asymptomatic man was referred to our institution because dilation of the MPD was revealed by abdominal ultrasonography (US). No tumor was detected by endoscopic ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). The diameter of the MPD was > 20 mm at the body, and no dilation was noted at the head. Although malignancy was not confirmed through cytology or imaging, pancreatic cancer was strongly suspected. Pancreaticoduo- denectomy was performed. Pathological and immunohistochemical examination revealed a 5 mm × 3 mm serotonin-positive endocrine tumor. Fibrosis was present around the MPD and seemed to cause stricture. A 32-year-old asymptomatic man had elevated serum amylase, and US demonstrated dilation of the MPD. No tumor was detected by CT and MRI. Pancreatic cancer was suspected due to stricture and dilation of the MPD. Pancreatectomy of middle part of pancreas was performed. Pathological and immunohistochemical examination revealed a serotonin-positive endocrine tumor sized 5 mm × 4 mm. We report 2 cases of serotonin-positive pancreatic endocrine tumors that caused stricture of the MPD in spite of the small size of the tumor.
