A case of small pancreatic neuroendocrine tumor of less than 10 mm showing metastasis to multiple organs.
Tomoki Ogata, Kazuo Hara, Nozomi Okuno et al.
✦ AI-curated · Sources linked
Case in brief
A woman in her sixties followed for a pancreatic body cyst for more than a decade developed a hypoechoic pancreatic lesion. Two EUS-guided fine-needle biopsies were nondiagnostic; later EUS showed extension into the main pancreatic duct. After distal pancreatectomy, histology identified an 8 × 7 mm G2 pancreatic neuroendocrine tumor. Multiple metastatic tumors were detected 4.5 years after surgery. She is undergoing treatment with everolimus and lanreotide.
What made this case unusual
Despite measuring less than 10 mm, the G2 tumor was followed by metastatic recurrence in multiple organs.
Diagnostic / clinical pearl
Nondiagnostic EUS-guided biopsies do not exclude a small pancreatic neuroendocrine tumor; evolving imaging findings, including main-duct extension, may inform further diagnostic assessment.
Why it matters
The case illustrates that small G2 pancreatic neuroendocrine tumors can metastasize, supporting careful follow-up rather than assuming that size alone indicates indolent behavior.