A Case Report of Nonfunctioning Islet Cell Carcinoma Developed Multiple Liver Metastasis 9 Years after the Initial Surgery

Kengo Kanetaka, Norihiro Kohara, Hiroyuki Yuzawa, Takayuki Hamada, Satoshi Awadu, Masashi Yamada, Junpei Maeda, Akimi Miyata, Minoru Amano and Kioko Kawai^*

Department of Surgery, Department of Pathology^*, Nagasaki Municipal Hospital

We present a case of islet cell tumor which recurred as multiple liver metastases, 9 years after the initial surgery in 1991. The patient was a 65 year-old Japanese man who underwent the resection of a nunfunctioning islet cell tunor at the age of 56, which we reported previously. He had had no symptoms or significant abnormalities in regular checkups until 1996, when abdominal ultrasonography revealed multiple nodules in the right lobe of the liver. Abdonimal computed tomography demonstrated that the rims of each nodule were well-enhanced after injection of contrast medium. The nodule centers were not enhanced, implying nocrosis. Other radiological examinations did not reveal any abnormal findings in the left lobe of the liver or in the gastrointestinal tract. With a diagnosis of recurrent islet cell tumor right lobectomy of the liver was performed. The histological examination obtained from the second operation showed that each of the nodules consisted of polygonal tumor cells arranged in solid and trabecular pattern, occasionally appearing in a ribbon-like pattern. These cells were Grimelius-stain positive. The histological findings were similar to those of the primary islet cell tumor resected 9 year before. The patient remains well without any evidence of the recurrence one year later. This fact suggests to us that surgical resection might provide a favorable prognosis in a patient with metastatic islet cell tumor, because of its slow-growing behavior.

Key words
nonfunctioning islet cell tumor, hepatic metastasis, surgical treatment

Reprint requests
Kengo Kanetaka Department of Surgery, Nagasaki Municipal Hospital 6-39 Shinchi, Nagasaki City, 850-8555 JAPAN

Accepted
March 31, 1999

To read the PDF file you will need Abobe Reader installed on your computer.