# Atypical presentation and diagnosis of a metastatic grade II pancreatic neuroendocrine tumor in a 52-year-old female patient: A case report

## TL;DR

A 52-year-old woman with a family history of cancer was diagnosed with a rare pancreatic neuroendocrine tumor that had already spread, highlighting the difficulty in early detection of such tumors.

## Contribution

This case report emphasizes the diagnostic challenges of metastatic PanNETs and the importance of considering them in patients with non-specific symptoms and risk factors.

## Key findings

- The patient presented with non-specific symptoms and was later diagnosed with a metastatic grade II pancreatic neuroendocrine tumor.
- Histopathology and imaging confirmed metastatic disease, leading to palliative treatment with octreotide.
- The case underscores the need for timely diagnosis and the potential of molecular screening to improve outcomes.

## Abstract

Pancreatic neuroendocrine tumors (PanNETs) are rare malignant neoplasms characterized by slow growth and variable clinical presentation. Although some secrete functional hormones, the majority remain clinically silent or manifest with non-specific symptoms, posing a challenge to early diagnosis. The present study describes the case of a 52-year-old female patient with a significant family history of malignancy, who presented with a syncopal episode following months of weight loss, fatigue and vague abdominal symptoms. A diagnostic workup revealed severe anemia and imaging findings consistent with metastatic disease. A computed tomogrpaphy-guided liver biopsy confirmed a moderately differentiated, grade II neuroendocrine tumor. Treatment with intramuscular octreotide was initiated, and the patient was discharged under palliative care. The case described herein underscores the clinical complexity and often subtle nature of PanNETs, and highlights the importance of considering them in the differential diagnosis of persistent constitutional symptoms, particularly in high-risk individuals. Timely diagnosis supported by histopathology and immunohistochemistry, combined with access to targeted therapies, is essential to improve the outcomes of patients. The integration of molecular screening and emerging therapeutic targets may transform the management of PanNETs, enabling earlier and more personalized interventions in the near future.