Open AccessEndocrine carcinoma of the pancreatic tail exhibiting gastric variceal bleeding
Author(s) -
Seng-Tang Wu,
Yuan-Min Chang,
JyhCherng Yu,
De-Chuan Chan,
ChungHsien Li,
GuJiun Lin,
Shing-Hwa Huang
Publication year - 2014
Publication title -
yīxué yánjiū zázhì/journal of medical sciences
Language(s) - English
Resource type - Journals
eISSN - 2542-4939
pISSN - 1011-4564
DOI - 10.4103/1011-4564.143650
Subject(s) - medicine , pancreas , upper gastrointestinal bleeding , splenectomy , gastric varices , splenic vein , endocrine system , gastroenterology , epigastric pain , carcinoma , stomach , plasmacytoma , radiology , pancreatic tumor , varices , cancer , portal hypertension , endoscopy , pancreatic cancer , hormone , multiple myeloma , spleen , cirrhosis , vomiting
Nonfunctional endocrine carcinoma of the pancreas is uncommon. Without excess hormone secretion, it is clinically silent until the enlarging or metastatic tumor causes compressive symptoms. Epigastric pain, dyspepsia, jaundice, and abdominal mass are the usual symptoms, whereas upper gastrointestinal (GI) bleeding is rare. Here, we describe the case of a 24-year-old man with the chief complaint of hematemesis. Upper GI panendoscopy revealed isolated gastric varices at the fundus and upper body. Ultrasonography and computed tomography showed a tumor mass at the pancreatic tail causing a splenic vein obstruction, engorged vessels near the fundus of the stomach, and splenomegaly. After distal pancreatectomy and splenectomy, the bleeding did not recur. The final pathologic diagnosis was endocrine carcinoma of the pancreas. Gastric variceal bleeding is a possible manifestation of nonfunctional endocrine carcinoma of the pancreas if the splenic vein is affected by a tumor. In non-cirrhotic patients with isolated gastric variceal bleeding, the differential diagnosis should include pancreatic disorders