Year 2025 / Volume 117 / Number 6
Letter
Acute pancreatitis as the initial manifestation of an ampullary neuroendocrine tumor

347-348

DOI: 10.17235/reed.2024.10567/2024

Daniel Muíño Domínguez, Noelia Rodríguez Ferreiro, María Helena González Sánchez, Marta García Calonge, Jacobo Martín Sanz, José Eduardo Villela Ramírez, Miriam Rubiera, Lorena Carballo Folgoso,

Abstract
Acute pancreatitis is a common condition in Gastroenterology. Among its possible etiologies are ampullary tumors, rare neoplasms whose growth can hinder pancreatic drainage. Although they are usually epithelial, adenomas and adenocarcinomas, less commonly other histological types have been reported, such as neuroendocrine tumors. They constitute a small percentage of both ampullary tumors and neuroendocrine tumors of the digestive tract, classified into three histological grades based on mitotic count and Ki-67. Although the diagnosis is usually incidental, its main form of presentation is clinical or analytical cholestasis, with acute pancreatitis being an exceptional initial presentation. Endoscopic resection is the treatment of choice for well-differentiated tumors without evidence of local infiltration of the duodenal wall or intraductal growth greater than 10mm, with endoscopic ultrasound playing a key role in this assessment. We present the case of a 45-year-old cholecystectomized woman who was admitted to our service with a condition compatible with acute pancreatitis, initially suspected to be of biliary origin. After several radiological and endoscopic studies, an enlargement of the duodenal papilla suggestive of ampulloma was detected. Histological examination demonstrated a well-differentiated neuroendocrine tumor of the duodenal papilla which, lacking evidence of local duodenal infiltration or intraductal growth, was successfully resected endoscopically.
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References
1. Ruiz Moreno M, Nieto Vitoria MA, Gómez Lozano M, et al. Neuroendocrine tumor of the ampulla of Vater. Review of the literature. Rev Esp Enferm Dig. 2023 Feb;115(2):99. doi: 10.17235/reed.2022.8981/2022.
2. Karlafti E, Charalampidou M, Fotiadou G, et al. Ampullary Large-Cell Neuroendocrine Carcinoma, a Diagnostic Challenge of a Rare Aggressive Neoplasm: A Case Report and Literature Review. Diagnostics (Basel) 2022 Jul 25;12(8):1797. doi: 10.3390/diagnostics12081797.
3. Saito K, Matsuo Y, Denda Y, et al. Neuroendocrine carcinoma of the minor papilla with pancreas divisum: a case report and review of the literature. J Med Case Rep. 2023 Mar 28;17(1):127. doi: 10.1186/s13256-023-03828-x.
4. Seo YK, Choi JS. Endoscopic Papillectomy for Synchronous Major and Minor Duodenal Papilla Neuroendocrine Tumors. Korean J Gastroenterol. 2018 Oct 25;72(4):217-221.doi: 10.4166/kjg.2018.72.4.217.
5. Varas Lorenzo MJ. Neuroendocrine tumors - fascination and infrequency. Rev Esp Enferm Dig. 2009 Mar;101(3):195-208.doi: 10.4321/s1130-01082009000300006.
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Muíño Domínguez D, Rodríguez Ferreiro N, González Sánchez M, García Calonge M, Martín Sanz J, Villela Ramírez J, et all. Acute pancreatitis as the initial manifestation of an ampullary neuroendocrine tumor. 10567/2024


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Publication history

Received: 28/05/2024

Accepted: 07/06/2024

Online First: 05/07/2024

Published: 10/06/2025

Article Online First time: 38 days

Article editing time: 378 days


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