PMC3036642_01
Contrast enhanced CT scan depicting the 1.5 cm solid mass in the uncinate process of the pancreas (arrow).
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F1
Abdominal ultrasonography (US) did not reveal any lesion, but a contrast enhanced CT scan demonstrated a 1.5cm solid mass in the uncinate process of the pancreas (Figure 1).
Microscopic focus of pancreatic adenocarcinoma with desmoplastic reaction (Hematoxylin-Eosin x 400).
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F2
However, the histopathological study featured a pancreatic adenocarcinoma of about 1mm in maximum diameter with intense desmoplastic reaction around the lesion (Figure 2).
Contrast enhanced CT scan, after the first operation, demonstrating a 2 cm mass in the uncinate pancreatic process, with characteristics of an endocrine neoplasm (arrow).
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F3
After two years, better CT image resolution presumably due to regression of the inflammatory phenomena, rendered the insulinoma mass detectable again, having at that time increased its size from 1.5cm to 2cm (Figure 3).
Pancreatic endocrine tumour ("insulinoma") adjacent to the pancreatic parenchyma (Hematoxylin-Eosin x 100).
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F4
The histopathological examination revealed a 2cm endocrine islet-cell tumour (Figure 4, 5) and the patient was discharged on the tenth postoperative day.
Pancreatic endocrine tumour, intensely immunostained for insulin (x 100).
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F5
The histopathological examination revealed a 2cm endocrine islet-cell tumour (Figure 4, 5) and the patient was discharged on the tenth postoperative day.