Undescribed metastases within a pancreatic neuroendocrine tumour

63-year-old male hospitalised due to jaundice. CT scan showed a mass in the pancreatic body and tail with vascular damage and amputation of the common bile duct. Retroperitoneal lymph nodes of pathological appearance and a 20 mm subcutaneous nodule compatible with metastasis were also described. There were no liver metastases [1].

Ultrasound-guided core needle biopsy of the subcutaneous nodule and endoscopic ultrasonography-guided fine needle aspiration of the pancreatic mass showed a high-grade neuroendocrine tumour positive for synaptophysin, CD56, chromogranin and CK19 in both cases. The hormonal study was normal, so it was a nonfunctional neuroendocrine tumour.

The patient also reported odynophagia, identifying in the exploration a mass in the right palatine tonsil with a malignant appearance. The histological study revealed a high-grade neuroendocrine tumour with the same immunohistochemical characteristics as the other two samples (positive for synaptophysin, CD56, chromogranin and CK19). Therefore, it was a tonsillar metastasis of a non-functioning pancreatic neuroendocrine tumour.

We have not found any reports on a pancreatic neuroendocrine tumour with tonsillar metastasis (a previously undescribed location of metastasis), or primary neuroendocrine tumours of the tonsil making this an exceptional case.

Publication History

Article published online:
27 March 2025

• References

• 1 Fernandes et al. Gastroenterol Clin N Am. 51. 2022: 625-647