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Non-functioning, malignant pancreatic neuroendocrine tumour (PNET): a rare entity during pregnancy
Carsten H Kamphues1, Christoph Röcken, Peter Neuhaus
1Department of General, Visceral and Transplantation Surgery, Universitätsklinikum Charité, Campus Virchow-Klinikum, Humboldt-Universität, Berlin, Germany. carsten.kamphues@charite.de
Introduction:
Non-functioning pancreatic neuroendocrine tumours (PNET) are extremely rare tumours. To our knowledge, we are the first to report in the literature on two cases of PNET during pregnancy.
Patients:
A 32- and a 35-year-old primigravida, both in their second trimester of pregnancy, were referred to our clinic because of a suspicious mass in the pancreas. Both patients had an uneventful medical history and their laboratory test results, including pancreatic hormones, were unremarkable. Both underwent surgical exploration and resection of the pancreatic tumour. One patient with a tumour in the pancreatic tail underwent a distal pancreatectomy and splenectomy, whereas in the other case a pylorus-preserving pancreaticoduodenectomy was performed due to a tumour in the pancreatic head.
Results:
One of the patients delivered a healthy infant, which is now at the age of 6 years in excellent health. The other patient is now in her third trimester of pregnancy without any further complications. Histopathological analysis of both tumours showed a strong expression of chromogranin and synaptophysin, thus both were classified as well-differentiated, non-functioning neuroendocrine carcinomas.
Conclusions:
Although PNETs are extremely rare, this entity can be confirmed as another differential diagnosis for suspicious pancreatic mass during pregnancy. In specialized centres, these tumours can be removed without any harmful consequences to the foetus.
