Pancreatic neuroendocrine tumor in a child of 3.5 years old
- PDF / 689,055 Bytes
- 3 Pages / 595.22 x 842 pts (A4) Page_size
- 14 Downloads / 227 Views
Pancreatic neuroendocrine tumor in a child of 3.5 years old Shirin Sayyahfar, Seyed Javad Nassiri, Mitra Mehrazma, Mahnaz Sadeghian Tehran, Iran
Methods: We present a 3.5-year-old girl with four weeks of icterus, who was misdiagnosed with hepatitis A. Results: The patient was finally diagnosed as having a low grade pancreatic neuroendocrine carcinoma. Conclusion: Pediatricians should be aware of or consider a tumor in differential diagnosis of jaundice, especially prolonged one in children. World J Pediatr June 2014; Online First Key words: hepatitis A; icterus; neuroendocrine tumor; pancreatic tumor
Introduction
N
euroendocrine tumors are referred to a heterogeneous group of neoplasms, which arise from neuroendocrine cells.[1] Pancreatic neuroendocrine tumors (PNETs) are relatively rare and represent 1%-2% of all pancreatic tumors.[1,2] The purpose of this article is to report a case of PNETs misdiagnosed with hepatitis A.
Author Affiliations: Department of Pediatrics (Sayyahfar S, Sadeghian M), Pediatric Surgery (Nassiri SJ) and Pathology (Mehrazma M), Iran University of Medical Sciences, Ali Asghar Children Hospital, Vahid Dastgerdi Street, Shariati Street, Tehran, Iran Corresponding Author: Shirin Sayyahfar, MD, Department of Pediatrics, Iran University of Medical Sciences, Ali Asghar Children Hospital, Vahid Dastgerdi Street, Shariati Street, Tehran, Iran (Tel: +98-21-22255218; Fax: +98-21-22220063; Email: [email protected] or sayyahfar_shirin@ yahoo.com) doi: 10.1007/s12519-014-0491-z
©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2014. All rights reserved.
World J Pediatr, Online First, June 2014 . www.wjpch.com
Case report
A 3.5-year-old girl with jaundice for 4 weeks, who had a positive total anti hepatitis A virus (anti-HAV) antibody test and a primary diagnosis of hepatitis A, was referred to Ali Asghar Children's Hospital. She had no fever, abdominal pain, or nausea before and after appearance of jaundice, but 2 kg of weight loss, dark urine, and clay-colored stool were observed during this period. She had no medical history of jaundice. Physical examination showed icterus and hepatomegaly (liver span: 10 cm) but splenomegaly. No tenderness or palpable mass was shown by abdominal examination. The primary laboratory data are shown in the Table. IgM anti-HAV, HBs Ag, and hepatitis C virus antibody (HCV Ab) tests were negative except IgG anti-HAV. The girl was diagnosed with a choledochal cyst by ultrasound examination, but abdominal CT scan with oral and intravenous (IV) contrast revealed an enhanced intermediate mass in the head of the pancreas, suggesting a hypervascular pancreatic lesion. Magnetic resonance cholangiopancreatography (MRCP) confirmed the dilation of the intra- and extra-hepatic biliary ducts and the common bile duct, which resulted to an ampullary mass (Fig. 1). The
Table. Initial blood test values (bold values are out of range) Tests Patient value Normal value SGOT (IU/L) 321 5-40 SGPT ( IU/L) 249 5-40 Total bili
Data Loading...
