case_images: PMC8337156_01
case_images: Hyperattenuating lesion in the anterior plane of the head of the pancreas (2.4 cm x 2.3 cm x 2.1 cm), bilateral adrenal hyperplasia, and nonvisualization of the left kidney.
case_images: CRIE2021-8842667.001.jpg
case_images: PMC8337156_01_CRIE2021-8842667.001.jpg
case_images: fig1
case_images: Contrast-enhanced computed tomography (CECT) abdomen showed a hyperattenuating lesion in the pancreatic head (2.4 cm x 2.3 cm x 2.1 cm) communicating with the main pancreatic duct and bilateral adrenal hyperplasia (Figure 1).
case_images: 99mTc MIBI scan showing right inferior parathyroid adenoma.
case_images: CRIE2021-8842667.002.jpg
case_images: PMC8337156_01_CRIE2021-8842667.002.jpg
case_images: fig2
case_images: Likewise, technetium-99m labeled hexakis-methoxyisobutyl isonitrile (99mTc MIBI) scan showed right inferior parathyroid adenoma (Figure 2).
case_images: Postoperative specimen.
case_images: CRIE2021-8842667.003.jpg
case_images: PMC8337156_01_CRIE2021-8842667.003.jpg
case_images: fig3
case_images: Classical pancreaticoduodenectomy (Whipple's procedure) was performed which showed 3 cm x 2 cm fleshy mass present in the pancreatic head (Figure 3) with no ascites, the pancreas was soft, and common bile duct measured about 12 mm.
case_images: Well-differentiated neuroendocrine tumor; tumor cells arranged in trabeculae, cords, and lobules with vascular septa. These cells show mild nuclear atypia, fine stippled chromatin, inconspicuous nucleoli, and moderate amount of eosinophilic granular cytoplasm. Mitosis is infrequent (H&E X100).
case_images: CRIE2021-8842667.004.jpg
case_images: PMC8337156_01_CRIE2021-8842667.004.jpg
case_images: fig4
case_images: Histopathological examination (HPE) revealed a well-differentiated neuroendocrine tumor (Figure 4) with a maximum tumor dimension of about 2.6 cm with lymph node metastasis.