Bleeding and malignant pancreatic neuroendocrine neoplasms: A Malaysian case series

Introduction: Pancreatic neuroendocrine neoplasm (PNEN) is a rare malignancy arising from the endocrine tissue of the pancreas. These tumors are classified based on functional (hormonal) status and malignant potential. Symptoms and signs are related to the hormonal function, tumor size, and metastatic effect. The majority are sporadic, non-functioning while insulinoma remains the most prevalent functional variety of these tumors. Case Series: We present two cases of PNEN with different presentations and treatments; one with a resectable disease who presented as a rare case of bleeding PNEN, and the other who was unresectable due to extensive metastatic PNEN. Conclusion: Pancreatic neuroendocrine neoplasm is a heterogeneous group of disorder with a multitude of clinical presentation. Each patient must be investigated and managed appropriately according to the treatment of Muthu Viknesh1, Faqihuddin Bin Hisham1, Padmaan Sankaran2, Soon Kong Choon3, Nik Azim Bin Nik Abdullah4 Affiliations: 1Medical Officer, Hepatobiliary Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia; 2Hepatobiliary Surgeon, Hepatobiliary Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia; 3Consultant Hepatobiliary Surgeon, Hepatobiliary Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia; 4Senior Consultant Hepatobiliary Surgeon, Hepatobiliary Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia. Corresponding Author: Muthu Viknesh, V304, MJC Courtyard Sanctuary, Batu Kawah New Township, Jalan Batu Kawa 93250, Kuching, Sarawak, Malaysia; Email: mtvvicky@gmail.com Received: 04 June 2019 Accepted: 29 July 2019 Published: 20 August 2019 choice. In keeping with the purpose of this article, we suggest a bleeding PNEN, a rare occurrence, is best managed with surgery, while unresectable metastatic PNEN would benefit from appropriate medical therapy.