Combined endocrine and exocrine tumours of the pancreas

Abstract

Background: Cystic neoplasms of the pancreas comprise 10%-15% of pancreatic cystic lesions, with the serous cystadenoms being the commonest. The association of exocrine and endocrine tumours of the pancreas unrelated to Von Hipple Lindau disease is very rare. Very few cases have been reported in the literature. We present another case of both these tumours in one patient.

Case presentation: A female patient was seen in the surgical clinic for a pain in the right groin. Clinical examination and investigations confirmed a diagnosis of combined endocrine and exocrine tumours of the pancreas. She underwent surgery and is under regular follow-up in the surgical clinic.

Conclusion: Biphasic differentiation of pancreatic stem cell during embryological development could happen and may result in combined endocrine and exocrine tumours of the pancreas. Imaging studies are excellent in diagnosing theses lesions. Surgery has a central role and could be curative.

Figure 1

CT abdomen showing the mass arising from the body and the tail of the pancreas and extending into the splenic hilum.

Figure 2

A low power view of the cystic spaces lined by cuboidal serous epithelium representing exocrine tumor with a cribriform sheet of endocrine tumor on the Right (×10).

Figure 3

Cystic spaces on the left lined by serous type epithelium with a small sheet of endocrine tumor composed of small uniform cells with round nuclei (×20).