Two Cases of Pancreatic Pure Cystic Endocrine Tumors Treated by Laparoscopic Distal Pancreatectomy

We report two cases of pancreatic cystic endocrine tumors treated by laparoscopic distal pancreatectomy. Case1: A 33-year-old woman was found with computer tomography to have a 4cm cystic tumor and a partially thickened septum in the body of the pancreas. The thickened septum showed enhancement with contrast medium. We suspected an intraductal papillary mucinous neoplasm or a mucinous cystic neoplasm, and performed laparoscopic distal pancreatectomy and splenectomy. Pathological examination of the resected specimen indicated a well differentiated endocrine tumor of uncertain nature. Case 2: A 62-year-old woman was found with computer tomography to have a 4cm cystic tumor and a partially thickened and hypervascular septum in the body of the pancreas. Suspecting a mucinous cystic neoplasm, a solid pseudopapillary tumor, or a cystic endocrine tumor, we performed laparoscopic distal pancreatectomy and splenectomy. Pathological examination of the resected specimen indicated glucagonoma. Neither woman has had recurrence as of this writing. We conclude that pancreatic cystic endocrine tumor is characterized by partial thickening and contrast enchancement of the septum. Laparoscopic surgery is a viable treatment for endocrine tumor of the pancreas.