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Two pp-omas of the head of the pancreas one of which with central necrosis fistulated into the duodenum

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Author(s): Čolović Radoje B. | Grubor Nikica M. | Micev Marjan | Čolović Nataša | Todorović Vera N. | Ćosić-Micev Milena

Journal: Srpski Arhiv za Celokupno Lekarstvo
ISSN 0370-8179

Volume: 131;
Issue: 5-6;
Start page: 259;
Date: 2003;
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Keywords: PP-oma | duodenum | fistula | duodenopancreatectomy

ABSTRACT
PP omas are rare, usually malignant tumors of the PP cells of the Langerhan¢s islets which secrete pancreatic polipeptide. The authors present two women operated for PP-omas of the pancreas. The first was 55 year-old woman in whom we did a cephalic duodenopan-createctomy (Whipple's procedure) for the tumor of the head of the pancreas with central cavity containing gas due to comunication with the duodenum. Imunohistochemistry showed a PP oma with strong generalised immunoreactivity with antibodies against Chromogra-min A, neuron specific enolasa and PP with more the 95% of tumor cells and coexpression of somatostatine in 35% and VIP in less then 5% of tumor cells. Following uneventful recovery the patient stayed symptom free so far and put 20 kilograms in weight. The second patient was 19 year-old girl with a multinodal tumor of almost the entire pancreas in whom a local excision of the nodal mass of the head of the pancreas had been carried out in the other hospital, three years ago and relaparotomy and tumor biopsy a month before admission to our institution. In her we did a total duodenopancreatectomy and standard limphadenectomy for a multinodal mass ocupying almost the entire pancreas. Immunohistochemistry showed a strong generalised immunoreactivity with antibodies agains Chromographin A, Neuron speciphic enolasa and PP for more then 95% of tumor's cells. Glucagon was expressed in few focuses (in less then 1% of cells), somatostatin was expressed very rarely in single cells while the rest of tumor markers did not show a visible immunologic reactions in the majority of tumor's cells. Three years after surgery she died due to multiple liver secondaries.
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