Tumeur pancréatique endocrine avec thrombus veineux néoplasique et métastases hépatiques bilobaires. Cas clinique illustrant la stratégie thérapeutique

We report the case of an asymptomatic pancreatic metastatic endocrine tumour, fortuitously discovered in a 56-year-old woman. CT-scan showed a huge left pancreatic mass invading the spleen and the stomach, with a neoplastic thrombus in the spleno-mesenterico-portal venous confluence and bilobar liver metastasis. A two-step surgical treatment was done: (1) enlarged left pancreatectomy, thrombectomy and left liver “clearance”; (2) right hepatectomy and radiofrequency after right portal vein embolization. Due to the completeness to the resection and the histopathological data, the patient did not receive any adjuvant therapy according to the French guidelines. Follow-up is one year without any recurrence.