Radical resection of large metastatic non-functioning pancreatic neuroendocrine carcinoma complicated by splenic vein thrombosis and sinistral portal hypertension

• Published in: International journal of surgery case reports 2021, Vol.81, p.105724-105724
• Main Authors: Kumar, S, Raobiakady, R, Watkins, D, Terlizzo, M, Bhogal, R H
• Format: Report
• Language: English
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2021.105724

INTRODUCTION AND IMPORTANCEThere are limited reports in the literature of radical surgical resection for pancreatic neuroendocrine carcinoma (PNEC). In patients with non-functioning PNEC (NF-PNEC) within the tail of the pancreas tumours can cause splenic vein thrombosis (SVT) and subsequent sinitral portal hypertension (SPH). Radical surgical resection in such patients with concomitant liver metastasis has not previously been reported. CASE PRESENTATIONWe present a 67-year old female patient who presented with a large NF-PNEC within the tail of the pancreas with liver metastasis. We performed a distal pancreatectomy, splenectomy, partial gastrectomy and liver resection to achieve radical resecton. DISCUSSIONAll patients with NF-PNEC within the tail of the pancreatic should be considered for radical surgical resection. In the presence of multi-visceral involvement and complications such as SVT and/or SPH multi-speciality surgical expertise is likely to be required. CONCLUSIONRadical multi-visceral resection for large NF-PNEC can be safely performed in the presence of SVT and SPH.