case_images: PMC11412808_01
case_images: (A, B) 68Ga-DOTA-NOC PET/CT scan before treatment showing the positive uptake in the pancreatic tail (SUV max 11.45). (C) 68Ga-DOTA-NOC PET/CT scan after surgery showing no hyperfixation foci.
case_images: fendo-15-1405835-g001.jpg
case_images: PMC11412808_01_fendo-15-1405835-g001.jpg
case_images: f1
case_images: T1-weighted images, with increased enhancement in relation to the surrounding pancreatic parenchyma. This was in favor of the hypothesis of a neuroendocrine tumor. 68Ga-SSTR PET/CT showed positive uptake in the pancreatic tail (SUV max 11.45), as shown in  Figure 1 . The patient underwent a caudal pancreatectomy with curative intent, which occurred without complications, and post-operative CT and 68Ga-SSTR PET/CT were negative, as shown in  Figure 1 . Mitotic figures were scarce (<1 per 2mm2) and Ki67 labeling was less than 3%.
case_images: (A) H&E staining showing the pancreas with multiple scattered foci of fibrosis and (B) neuroendocrine cell hyperplasia including a pNET with low Ki67 labeling. (C) The pNET was strongly positive for staining for glucagon (ref. 565860, BD Pharmingen) on immunohistochemistry, and (D) the pancreatic islets depicted over 80% of the cells staining positive for glucagon, while the percentage in normal human islets is usually under 50% even considering the larger relative proportion observed in pancreas from individuals with T2D.
case_images: fendo-15-1405835-g002.jpg
case_images: PMC11412808_01_fendo-15-1405835-g002.jpg
case_images: f2
case_images: T2D. These findings were compatible with the pathological diagnosis of glucagon-producing NET and ACH ( Figure 2 ).