Neuroendocrine tumor of the pancreas causing biliary obstruction in a 12 year-old girl: A case report and literature review

• Pancreatic tumors are uncommon in children and rarely result in biliary obstruction.
• We present a case of a 12 yr old girl who presented with painless, obstructive jaundice due to a pancreatic neuroendocrine tumor in the head of her pancreas, requiring a pancreaticoduodenectomy.
• Complete surgical resection was obtained and the child recovered uneventfully.
• Overall survival is significantly better among children with localized disease compared to those with distant spread.

Pancreatic tumors are uncommon in children and rarely result in biliary obstruction. A previously well 12-year old female presented with a one-week history of fatigue, pruritis, and painless jaundice. Abdominal ultrasound demonstrated a mass in the pancreatic head associated with dilation of the common bile duct. Further workup included abdominal MRI, CT and endoscopic retrograde pancreaticogram (ERCP) with biliary stenting. Octreotide scan did not reveal uptake in the pancreatic tumor. Percutaneous biopsies were consistent with a grade 2 pancreatic neuroendocrine tumor (NET). Preoperative imaging demonstrated involvement of the portal vein. The patient was brought the operating room for a pancreaticoduodenectomy and portal vein resection. Final pathology revealed a T3N1M0 pancreatic NET. The patient recovered uneventfully.