Spontaneous rupture of a non-functioning pancreatic neuroendocrine tumor A case report of a rare cause of acute abdomen

Abstract

BACKGROUND: Pancreatic neuroendocrine tumors (PNETs) are a group of rare tumors that account for 2% of all pancreatic malignancies, even though their incidence has been increasing over the past 20 years. Most PNETs are sporadic
and tend to afect older individuals. Diferently from functional tumors, which present with symptoms resulting from the
speciic hormone being elaborated, non-functioning pancreatic neuroendocrine tumors (NF-PNETs) typically present with
symptoms related to local mass efect or metastatic disease. Today, due to the increasing use of abdominal imaging, NFPNETs are frequently discovered incidentally.

CASE REPORT: A 32-year-old woman was admitted to our emergency department for worsening upper abdominal pain
radiating to the back. Shortly after the admission, shock and peritoneal signs developed. An abdominal computerized
tomography scan showed a solid mass (9 x 12 cm) of the pancreatic tail with severe hemoperitomeum. Exploratory
laparotomy and subsequent distal splenopancreasectomy were performed for a bleeding tumor. Histopathological report
showed a neuroendocrine, well diferentiated tumor (G1). he postoperative course was uneventful and the patient was
successfully discharged on 10th postoperative day.

CONCLUSION: Spontaneous rupture of solid neuroendocrine neoplasms of the pancreas can cause acute abdomen with
potentially devastating efects