Most neuroendocrine tumors (NETs), like other tumors, are clinically silent, producing symptoms only as a consequence of tumor growth. Pancreatic NETs account for only 1% of pancreatic cancers by incidence, while representing 10% of all pancreatic cancers by 28-year limited duration prevalence. Here, we present a 47-year-old man with abdominal pain, icterus, itching and 8 kg weight loss during 5 months. Elevated liver enzymes, direct bilirubin and alkaline phosphatase were observed. Magnetic resonance cholangiopancreatography showed a prominence at the head of the pancreas and also liver cysts. Endoscopic ultrasound of the pancreas was performed and a specimen was obtained via fine needle aspiration. Immunohistochemical staining was performed and the result was compatible with NET. The patient referred to receive chemotherapy.