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Endoscopy 2008; 40(7): 602-605
DOI: 10.1055/s-2007-995740
Case report

© Georg Thieme Verlag KG Stuttgart · New York

EUS and clinical characteristics of cystic pancreatic neuroendocrine tumors

P.  Kongkam1 , M.  Al-Haddad1 , S.  Attasaranya1 , J.  O’Neil1 , S.  Pais1 , S.  Sherman1 , J.  DeWitt1
  • 1Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana, USA
Further Information

Publication History

submitted 7 November 2007

accepted after revision 10 March 2008

Publication Date:
08 July 2008 (online)

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Pancreatic neuroendocrine tumors (PNETs) may rarely appear as cystic or mixed solid-cystic masses. The endoscopic ultrasound (EUS) morphology and cyst fluid characteristics of these tumors are not well clarified. We retrospectively identified nine adult patients with nine single cystic pancreatic neuroendocrine tumors (CNETs). These nine included 0.67 % of the 1344 patients with pancreatic cystic lesions and 9.5 % of the 95 confirmed PNETs evaluated over the 12-year study period. At presentation, four patients were asymptomatic and five had known acute pancreatitis (n = 2), MEN-1 syndrome with hypoglycemia (n = 1), and abdominal pain (n = 2). Median maximal tumor diameter was 26 mm (range 20 – 64 mm). EUS morphology was mixed solid and cystic (n = 4) or cystic alone (n = 5). Cytology from EUS-fine-needle aspiration (FNA) (median 2 passes; range 1 – 6) demonstrated a PNET, and immunocytochemistry was confirmatory in all patients. Cyst fluid carcinoembryonic antigen (CEA) (n = 4) and amylase (n = 5) ranged from 0.1 to 1.8 ng/ml (normal 0 – 2.5 ng/ml) and 72 to 1838 U/L (normal 25 – 161 U/L), respectively. Six patients underwent surgery, and the preoperative diagnosis was confirmed in all.

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J. M. DeWitt, MD 

Department of Medicine
Division of Gastroenterology and Hepatology
Indiana University Medical Center

550 North University Blvd.UH 4100
Indianapolis
IN 46202-5121
USA

Fax: +1-317-278-8144

Email: jodewitt@iupui.edu