Solitary concomitant endocrine tumor and ductal adenocarcinoma of pancreas

World J Gastroenterol. 2010 Jun 7;16(21):2692-7. doi: 10.3748/wjg.v16.i21.2692.


Pancreatic tumors with combined exocrine and endocrine features are rare. Most reported cases are classified as mixed exocrine and endocrine carcinoma of the pancreas. We report the first case of solitary concomitant endocrine tumor and ductal adenocarcinoma of the pancreas. A 58-year-old patient was admitted for uncontrolled diabetes mellitus and body weight loss. The tumor was fortuitously discovered in the pancreatic tail after a tumor survey panel. Grossly, the solitary tumor had a central fibrous band that clearly divided it into two parts. On microscopic examination, the tumor contained both endocrine and exocrine components distinctly separated by the central fibrous band. The exocrine part showed a poorly-differentiated adenocarcinoma. The endocrine part was strongly immunoreactive to chromogranin, synaptophysin and glucagon. We reviewed the literature on pancreatic tumors with combined exocrine and endocrine features. A simple classification for this group of neoplasms is suggested, including five types: amphicrine, mixed, collision, solitary concomitant and multiple concomitant.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / pathology*
  • Biomarkers, Tumor / metabolism
  • Carcinoma, Pancreatic Ductal / complications
  • Carcinoma, Pancreatic Ductal / diagnosis
  • Carcinoma, Pancreatic Ductal / pathology*
  • Chromogranin A / metabolism
  • Endocrine Gland Neoplasms / complications
  • Endocrine Gland Neoplasms / diagnosis
  • Endocrine Gland Neoplasms / pathology*
  • Glucagon / metabolism
  • Humans
  • Hyperglycemia / etiology
  • Hyperglycemia / therapy
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / pathology*
  • Synaptophysin / metabolism


  • Biomarkers, Tumor
  • Chromogranin A
  • Hypoglycemic Agents
  • Synaptophysin
  • Glucagon