A Curative Case of Small Cell Carcinoma of the Pancreas -A Review of 22 Cases Reported in the Japanese Literature-

Naoshi Kubo, Yoshiaki Koh, Atsunori Nitta, Akimasa Inui and Hazime Tanaka

Department of Surgery, Seichokai Huchu Hospital

A 44-year-old man admitted for acute abdomen was found on physical examination to have signs of peritoneal irritation. Laboratory findings indicated repidly progressive anemia. Abdominal ultrasonography (US) and computed tomography (CT) showed splenic ruputure and intraabdominal hemorrhage.
Emergency laparotomy showed a large amount of coagulated blood in the peritoneal cavity and a ruptured spleen.
The body and tail of the pancreas were firm. After splenectomy, intraoperative US showed a hypoechoic irregular mass in the body of the pancreas suspected of malignancy. Distal pancreatectomy with lymph node dissection showed the resected mass to be a white, firm 27×15×15 mm tumor. Histological findings closely resembled small cell carcinoma (SCC) of the lung. Special staining for neuron specific enolase (NSE), chromogranins A, grimelius silver and epithelial menbrane antigen (EMA) were positive. Because further examination of the lung including CT detected no lesion, we diagnosed the tumor as SCC of pancreatic origin. Such SCC is very rare, with only 22 cases reported in the Japanese literature, including our case. After radiotherapy, the patient was discharged without complication and is doing well with no evidence of reccurence 24 months after surgery.

Key words
small cell carcinoma, pancreas

Reprint requests
Naoki Kubo Seichokai Huchu Hospital Department of Surgery 1-10-17 Higo town, Izumi city, 594-0076 JAPAN

Accepted
September 25, 2002

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