[Pancreas carcinoid with extensive liver metastasis--simultaneous excision]

This case report describes an unusually large islet cell tumour of the pancreas presenting clinically with extensive metastases in the liver. The patient involved was a 55-year-old woman. The leading symptom was severe, hardly tractable diarrhoea. Histological examination including immunohistochemistry and measurements of the proliferation index revealed a probable malignant Vipoma of low grade. It was treated by simultaneous R0 resection of the tumour masses; the postoperative course was unremarkable. This outcome is seen as a strong argument in favour of a radical surgical approach even if there is significant metastatic disease in the liver. The advantage of intraoperative ultrasound is discussed along with aspects of tumour classification and alternative therapeutic modalities.