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2026, Number 3-4

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Rev Mex Cir Endoscop 2026; 27 (3-4)

Cystic neuroendocrine tumor of the pancreas solved with distal pancreatectomy with splenic preservation (Kimura technique). Case report

Huerta-Gasca KG, Lira-Cerda A, Salgado-Sánchez E, Riedel-Caballero EN, Robredo-Galindo A, Gómez-Mondragón BI, Pérez-Cervantes DH

Language: Spanish
References: 15
Page: 106-111
PDF size: 1789.00 Kb.


ABSTRACT

Introduction: cystic pancreatic neuroendocrine tumors (cPanNETs) are uncommon and may mimic other pancreatic cystic lesions, making preoperative diagnosis challenging. Their low frequency and the scarcity of national reports highlight the value of documenting individual cases. Case report: a 71-year-old man presented with mild left flank pain and chronic diarrhea. Physical examination was unremarkable. Laboratory tests showed elevated amylase, lipase, and alpha-fetoprotein (AFP). Contrast-enhanced tomography identified a well-defined cystic lesion in the pancreatic tail. Due to persistent symptoms, suspicion of a cystic neoplasm, and the patient’s preference, laparoscopic distal pancreatectomy was indicated. A laparoscopic spleen-preserving distal pancreatectomy (Kimura technique) was performed, with 30 mL blood loss and a 90-minute operative time. Histopathological analysis confirmed a well-differentiated cystic pancreatic neuroendocrine tumor (G1), measuring 45 mm, with no lymphovascular or perineural invasion, negative margins, and confinement of the tumor to the pancreas. Conclusion: spleen-preserving laparoscopic distal pancreatectomy is a safe and effective approach for cystic PanNETs of the pancreatic tail. This case emphasizes the need to consider these tumors in the differential diagnosis of pancreatic cystic lesions and supports the importance of reporting national experiences to strengthen clinical and surgical knowledge in Mexico.


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