Primary Carcinoid Tumour of the Pancreas with Atypical Presentation
SNA Rashid, SA Hamid, SM Saini, GC Gan
Hong Kong J Radiol 2012;15:105-9
Carcinoid tumours of the pancreas are extremely rare. We report a very unusual case of carcinoid tumour of the pancreas with extensive regional lymph node involvement and no liver metastasis in a patient with worsening jaundice; the patient was otherwise asymptomatic. Dilated intrahepatic and extrahepatic ducts with no calculi or mass within the liver or pancreas were noted on abdominal ultrasound. Enhanced abdominal computed tomography showed extensive enlarged abdominal lymph nodes, a thickened duodenal wall, and dilated biliary tree, as well as common bile duct and pancreatic duct. The pancreas appeared normal. A periampullary tumour with a distal common bile duct stricture and dilatation of the common bile duct was seen on endoscopic retrograde cholangiopancreatography. Endoscopic ultrasonography examination showed a diffusely enlarged and irregular mass at the head of the pancreas, and histology of biopsy samples was consistent with a neuroendocrine tumour.
中文摘要
胰腺原發類癌腫瘤的非典型症狀
SNA Rashid, SA Hamid, SM Saini, GC Gan
胰腺的類癌腫瘤非常罕見。本文報告一名胰腺類癌腫瘤患者，其淋巴結廣泛受累，但無肝轉移；病 人除了有不斷惡化的黃疽病外，並無異常。腹部超聲顯示其肝內膽管和肝外膽管擴張，但肝臟和胰 腺內並無發現結石或腫塊。增强腹部電腦斷層掃描顯示廣泛腹腔淋巴結脹大、十二指腸壁增厚，膽 管樹、膽總管及胰管擴張。胰腺顯示正常。內窺鏡逆行胰膽管造影顯示壺腹周圍腫瘤，並有膽總管 下端狹窄，膽總管擴張。內窺鏡超聲成像顯示在胰腺頭部彌漫性不規則腫塊灶，活檢組織學結果吻 合胰腺神經內分泌腫瘤。