Massive pancreas neuroendocrine tumor
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Very large, lobulated, heterogeneous mass arising from the pancreas body/tail filling much of the left upper abdomen and invading the splenic hilum and splenic flexure (colon). Occlusion of the splenic vein with numerous short gastric collaterals. Cluster of suspicious lymph nodes along the inferior aspect of the mass. Single suspicious thoracic lymph node adjacent to the aorta.
EUS with biopsy was performed confirming a low-grade neuroendocrine tumor (NET) The very large size of the mass with only a few nodal metastases can help favor a lower-grade, more slowly growing tumor such as NET instead of adenocarcinoma which is usually smaller and more infiltrative at presentation.