A Case of Somatostatinoma of the Pancreas, Accompanied with Pancreas Divisum, that was Found at a Time of Acute Pancreatitis

Hideki Matsuba, Kenji Kato, Kiyosi Hiramatsu, Takaaki Ito, Takashi Akagawa, Yasushi Kutsuna, Yuichi Machiki, Susumu Fujioka and Katsue Yoshida*

Department of Surgery and Department of Pathology*, Kiryu Kosei General Hospital

Somatostatinoma is an extremely rare endocrine tumor originated mainly in the pancreas or duodenum. We report a case of somatostatinoma of the pancreas. The patient had the pancreas divisum, and the accesssory pancreatic duct that had become the main drainage duct was obstructed by the somatostatinoma, causing acute pancreatitis. 65-years-old man reported upper abdominal pain, diagnosed as acute pancreatitis. In ERP after recovery from acute pancreatitis, we found "pancreas divisum," in which the dorsal and ventral pancreatic ducts communicate only with the branch, and the accesssory pancreatic duct was interrupted and dilated. An ulcerative tumorous lesion was found in the second portion of the duodenum in fiber scopic studies. We thought that the accesssory pancreatic duct was interrupted by the tumor and acute pancreatitis developed. A preoperative diagnosis of duodenal or pancreatic carcinoma was made and we conducted pancreaticoduodenectomy. The pathological diagnosis was an endocrine tumor of the pancreas. Immunohistochemical staining for somatostatin was positive. We defined the diagnosis as somatostatinoma of the pancreas.

Key words
somatostatinoma, pancreas divisum, acute pancreatitis

Reprint requests
Hideki Matsuba Department of Surgery, Kiryu Kosei General Hospital
6-3 Orihimecho, Kiryu, 376-0024 JAPAN

Accepted
May 31, 2006

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