Nonfunctioning Neuroendocrine Carcinoma of Pancreas Presenting with Lower Gastrointestinal Bleeding: Report of a Case

胰臟的神經內分泌腫瘤是少見的腫瘤，約佔胰臟腫瘤的0.5%。其中，無功能性的胰臟神經內分泌腫瘤最常見的臨床症狀是腹痛，其次為體重減輕。在此，我們報告一個以下消化道出血為臨床表現的胰臟無功能性神經內分泌腫瘤病例。這位55歲的男性病患，於入院前5個月開始出現間歇性的血便。大腸鏡檢查發現結腸內有一個具表淺糜爛的腫瘤，切片檢查並沒有發現惡性細胞。雙對比鋇灌攝影發現靠近脾曲處有腸腔狹窄。腹部電腦斷層發現一個血管豐富的腫瘤在胰臟尾部合併有脾臟及結腸侵犯。手術時，發現一個9.5×7.5×6.5厘米大的腫瘤在胰臟尾部。組織病理學檢查為分化良好的神經內分泌癌合併結腸侵犯，但是無淋巴結轉移的情形。病人在接受手術後，迄今未再出現臨床症狀。據我們所知，這是首例無功能性的胰臟神經內分泌癌侵犯結腸，而以下消化道出血為臨床表現的病例。

關鍵字

無功能性的胰臟神經內分泌瘤；胰臟；消化道出血

並列摘要

The most common presenting symptom of nonfunctioning neuroendocrine tumors of the pancreas is abdominal pain. Herein, we report a case of nonfunctioning neuroendocrine carcinoma of the pancreas presenting with lower gastrointestinal bleeding. A 55-year-old male patient complained of intermittent bloody stool passage for 5 months. Colonoscopy revealed a mass-like lesion with superficial erosions in the colon, however the biopsy was negative for malignancy. Abdominal computed tomography demonstrated a hypervascular tumor over the tail of the pancreas with colonic and splenic invasion. He underwent surgical intervention, and a tumor measuring 9.5×7.5×6.5 cm over the pancreatic tail was found. Histopathological examination of the tumor revealed a well-differentiated neuroendocrine carcinoma with colonic and splenic invasion. The patient was symptom-free following the operation. To the best of our knowledge, this is the first report of nonfunctioning neuroendocrine carcinoma presenting with colon invasion and lower gastrointestinal bleeding.

並列關鍵字

nonfunctioning neuroendocrine tumor ； pancreas ； gastrointestinal bleeding

國際替代計量

Nonfunctioning Neuroendocrine Carcinoma of Pancreas Presenting with Lower Gastrointestinal Bleeding: Report of a Case

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