Pancreatic Neuroendocrine Tumour Causing Chronic Diarrhoea: Radiological-Pathological Correlations

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YY Cheuk, WK Lo, SK Chan, CW Wong

Hong Kong J Radiol 2014;17:45-8

DOI: 10.12809/hkjr1412150

This report is of an unusual case of chronic diarrhoea due to a pancreatic neuroendocrine neoplasm. A 57-year-old man presented to Kwong Wah Hospital, Hong Kong with chronic diarrhoea for more than 1 year. A wide spectrum of investigations was performed, including complete blood counts, liver and renal function tests, thyroid function test, stool culture, and colonoscopy, which showed no abnormalities. Contrast computed tomography of the abdomen and pelvis subsequently showed a 5-cm well-circumscribed hypoenhancing pancreatic tail mass. In view of the clinical presentation, a pancreatic neuroendocrine tumour was diagnosed. Octreotide scan showed strong tracer uptake at the pancreatic tail tumour, with no other tracer uptake focus. Positron-emission tomography–computed tomography scan showed a solitary hypermetabolic pancreatic tail tumour with no evidence of distant metastases. Endoscopic ultrasound-guided fine-needle aspiration cytology showed features of pancreatic neuroendocrine tumour. Pancreatic neuroendocrine neoplasms are rare tumours. Clinical, biochemical, and radiological correlations are essential in making an accurate preoperative diagnosis. Imaging played a central role in detection, localisation, and subtype differentiation of this tumour. Knowledge of the features of the various imaging techniques could aid in diagnosis, treatment planning, prognosis, and disease monitoring.






本文報告一個由胰腺神經內分泌腫瘤引致罕見的慢性腹瀉。一名到香港廣華醫院求診的57歲男性患有慢性腹瀉一年多。包括全血球計數、肝腎功能檢查、甲狀腺功能檢查、大便細菌培植和大腸鏡的各種檢查結果均未有發現異常。及後,病人被安排進行腹盆對比電腦斷層造影,發現一個5 cm的胰尾腫瘤。在綜合病人的臨床表徵後,診斷出胰腺神經內分泌腫瘤。奧曲肽掃描顯示這胰尾腫瘤表現出較強的吸收,而腫瘤沒有擴散跡象。正電子—電腦斷層掃描亦顯示腫瘤無遠處轉移的證據。內鏡超聲引導針吸細胞學印證了腫瘤具神經內分泌腫瘤的特徵。胰腺神經內分泌腫瘤是一種罕見的腫瘤。準確的術前診斷須結合臨床、生化和醫學影像特徵。醫學影像在腫瘤檢測、定位和亞型分類中起着核心的作用。熟悉胰腺神經內分泌腫瘤在各種醫學影像的特徵有助術前診斷、治療計劃、預後判斷和疾病監測。