Resection of a non-functioning islet cell carcinoma occupying the entire pancreas

A 46-year-old woman with jaundice was found to have enlargement of the enti re pancreas on computed tomography. Endoscopy revealed a tumor at the papil la of Vater, although examination of biopsy specimens did not demonstrate a malignancy. The jaundice resolved spontaneously, but reappeared at 7 month s. Also noted was increased swelling of the papilla. The serum pancreatic e ndocrine and exocrine hormone concentrations were within the reference rang es. At surgery, a hard mass was found occupying the entire pancreas. Examin ation of incisional biopsy specimens from the pancreatic mass and papilla o f Vater revealed an islet cell tumor. A total pancreatectomy was performed. The tumor extended from the pancreatic tail to the papilla of Vater. Histo pathologic and immunopathologic examination revealed a nonfunctional islet cell carcinoma. There was no evidence of recurrence at 3 years. A good outc ome can be achieved with resection of non-functioning islet cell carcinomas , even if they are advanced.