[A Case of Achieving Radical Cure While Preserving the Function of the Pancreatic Body in a Patient with Double Primary Tumors of Pancreatic Head Cancer and Pancreatic Tail NEN].

Abstract

While pancreatic ductal adenocarcinoma (PDAC) originates from exocrine cells of the pancreas, pancreatic neuroendocrine neoplasms (PNENs) arise from pancreatic neuroendocrine cells. The concurrent presence of an exocrine pancreatic tumor and a pancreatic neuroendocrine tumor is referred to broadly as a pancreatic collision tumor. In cases where the lesions are spatially distant, they are termed as multiple primary tumors, a relatively uncommon occurrence. For both, surgical radical resection contributes to improved prognosis. Therefore, accurate evaluation of factors such as tumor number and localization is essential to determine the necessity of radical resection. However, compared to solitary tumors, this often leads to more extensive surgery. We performed subtotal stomach-preserving pancreaticoduodenectomy and distal pancreatectomy (including splenectomy) for a male patient in his 60s with pancreatic head adenocarcinoma and pancreatic tail neuroendocrine tumor (NET) G2. We sought to achieve an insulin-free outcome by preserving the function of the pancreatic body. We report a case where surgical techniques were optimized to enhance postoperative quality of life.