Laparoscopic right hemicolectomy with excision of a pancreatic neuroendocrine tumor (pNET)
Epublication WebSurg.com, Nov 2019;19(11). URL: http://websurg.com/doi/vd01en5793
Pancreatic neuroendocrine tumors (pNETs) are rare neoplasms, which account for less than 5% of all pancreatic tumors, with an incidence of 0.48 cases/100,000. They may be benign or malignant and tend to grow slower than exocrine tumors. They develop from the abnormal growth of endocrine cells in the pancreas and are either functional or nonfunctional, and may or may not cause signs or symptoms. Pancreatic NETs that have not spread outside the pancreas should be completely removed, if possible, because these tumors are more likely to be cured with surgery. This video shows a case of a pNET of the uncinate process, discovered in the study of a right colon cancer. Because of the small size of the pNET and its location, the association of a right laparoscopic hemicolectomy with a pancreatic tumor excision was deemed feasible. The mobilization of the mesenteric root allowed to identify the uncinate process and to prepare for the pNET excision. After the exposure of the duodenum and the retroperitoneal plane, the surgery continued with a right hemicolectomy and a complete mesocolic excision. An intracorporeal anastomosis was constructed and the surgical specimen was retrieved through a suprapubic incision. The pathological report revealed a T2N1 caecal adenocarcinoma and a G2 pNET.