A 41-year-old asymptomatic man was, by chance, diagnosed as having a mass in the left upper quadrant of the abdomen by ultrasound. Computed tomography and magnetic resonance imaging showed a slightly enhanced heterogeneous mass, measuring about 5 cm in diameter, adjacent to the pancreas tail and spleen. On abdominal angiography the
tumor was found to be fed by the splenic artery, and no encasement was observed. At operation the
tumor was connected to the pancreas tail and attached to the spleen, and no
metastasis was evident. As a result of these observations, a curative resection was performed. On histological examination the
tumor cells had no ductal or architectural organization and were continuous to the normal pancreatic tissues. The cells were negative for Grimelius argylphile and the
periodic acid schiff
stain. Immunohistochemistry indicated that the
tumor cells were positive for
keratin and
epithelial membrane antigen, but negative for
chromogranin A,
vimentin, alpha1-antitrypsin and alpha1-antichymotrypsin. The
tumor was diagnosed as a
small cell carcinoma of the pancreas, which is a
rare disease. In previously reported cases curative resection of the
tumor had not been possible because of its rapid progression and
metastasis, and the prognosis is generally very poor. In our case, however, curative resection of the
tumor was done, and the patient is healthy with no signs of recurrence for 56 months after the operation and with no additional
therapy.