Pancreatic neuroendocrine tumors (PNET) account for less than 2% of all pancreatic tumors, while cystic PNETs account for only 10–18% of all resected PNETs. The most common site for metastasis is the liver. Few detailed guidelines currently exist for management of stage 4 cystic PNETs. This is a unique case that was managed with complete surgical resection in one sitting. Our report is on a young male patient who was initially misdiagnosed as having a pancreatic pseudocyst and treated accordingly. He was finally diagnosed with PNET but was reluctant to undergo surgery until he developed bilobar hepatic metastasis. We performed a pylorus-preserving pancreaticoduodenectomy with a Roux-en-Y hepaticojejunostomy and wedge resection of both hepatic metastatic deposits. Cystic PNETs are rare and commonly misdiagnosed as pancreatic pseudocysts. Surgical resection is considered ideal, but sparse literature exists on the management due to a paucity of cases. We have reported this case as it was successfully managed with single-stage surgery for both the primary tumor as well as bilobar hepatic metastatic deposits, and no similar cases have been reported in literature. The follow-up scan revealed no residual disease.

中文翻译：

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误诊囊性胰腺神经内分泌肿瘤伴双叶肝转移一期切除术一例报告

胰腺神经内分泌肿瘤 (PNET) 占所有胰腺肿瘤的比例不到 2%，而囊性 PNET 只占所有切除 PNET 的 10-18%。最常见的转移部位是肝脏。目前很少有关于 4 期囊性 PNET 管理的详细指南。这是一个独特的病例，通过一次完整的手术切除来治疗。我们的报告涉及一名年轻男性患者，他最初被误诊为胰腺假性囊肿并接受了相应治疗。他最终被诊断出患有 PNET，但不愿接受手术，直到出现双叶肝转移。我们进行了保留幽门的胰十二指肠切除术，并采用 Roux-en-Y 肝空肠吻合术和楔形切除术切除两个肝转移灶。囊性 PNET 很少见，通常被误诊为胰腺假性囊肿。手术切除被认为是理想的，但由于病例较少，关于治疗的文献很少。我们报道了该病例，因为它通过一期手术成功治疗了原发肿瘤和双叶肝转移沉积物，文献中尚未报道类似病例。后续扫描显示没有残留疾病。