CYSTIC TUMORS AND ENDOCRINE TUMORS OF THE PANCREAS - A RARE ASSOCIATION

Cystadenomas and cystadenocarcinomas are the most common cystic tumors of the pancreas. Their inner lining contains neuroendocrine cells tha t may, in rare cases, produce a systemic syndrome. Similarly, digestiv e or pancreatic endocrine tumors have been reported in association wit h cystic tumors of the pancreas. We report a case of cystadenocarcinom a of the pancreas head, associated with a serous cystadenoma and an en docrine turner of the body of the pancreas. In a 70 year old patient, jaundiced due to obstruction of the extra-hepatic bile ducts, the abdo minal ultrasound and CT scan showed a hypoechogenic hypodense lesion o f the pancreas head resulting in an enlargement of the common bile duc t and pancreatic duct. Echoendoscopy confirmed the diagnosis and gave additional information; it showed that the cephalic lesion was heterog enous, with anechogene spaces separated by coarse echogenic septae ass ociated to a solid contingent. Also detected by echoendoscopy was a cy stic lesion containing thin spetae and a contiguous hypoechogenic nodu le of the body of the pancreas. Histology of the specimen following to tal pancreatecromy revealed a cephalic cystadenocarcinoma associated w ith a serous cystadenoma and a non-secreting endocrine tumor of the bo dy region. This observation highlights the usefulness of echoendoscopy in the work-up of cystic lesions of the pancreas; indeed, the turners of the body of the pancreas were nor detected by others methods. Furt hermore, there are reports in litterature on endocrine secretion syndr omes secondary to digestive endocrine rumors or neuroendocrine cells i n the lining of cystic rumors of the pancreas.