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Nonfunctioning islet cell tumor presenting with ascites and portal hypertension
Summary
Nonfunctioning islet cell tumors are rare and often asymptomatic. This case highlights a large, malignant islet cell tumor presenting with ascites and portal hypertension in a young woman, leading to a fatal outcome.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Nonfunctioning islet cell tumors (NF-ICTs) are rare pancreatic neoplasms.
- Typically, NF-ICTs remain asymptomatic until advanced stages.
Observation:
- A 22-year-old woman presented with a palpable mass, refractory high-protein ascites, and left-sided portal hypertension.
- Imaging revealed a large mass at the splenic hilum with significant collateral vasculature.
Findings:
- Exploratory laparotomy identified a 30 cm x 15 cm mass infiltrating the spleen.
- Histopathological examination confirmed a malignant islet cell tumor with splenic invasion.
Implications:
- This case underscores the potential for aggressive presentation of NF-ICTs, even in young patients.
- Large, symptomatic NF-ICTs pose significant surgical and management challenges, with potentially poor prognoses.