Objectives Neuroendocrine tumors of the pancreas are rare specifically in pediatric age group. We report a 3.5-year-old girl with four weeks of icterus and primary misdiagnosis of hepatitis A and final diagnosis of well differentiated low grade neuroendocrine carcinoma of the pancreas. With our best knowledge this is the first report of this tumor in under –5-year-group.
We highlight the patient’s presentation, examination, and management as well as review the characteristics of pancreatic neuroendocrine tumors.
Methods A retrospective case study of a 3.5-years-old girl with history of 4 weeks Jaundice, weight loss, hepatomegaly and positive total anti HAV antibody without fever, abdominal pain, vomiting, or palpable mass in abdominal examination.
Results IgM anti HAV, HBs Ag, and HCV Ab were all negative except for IgG anti HAV. Abdominal CT scan with oral and IV contrast revealed an intermediate enhancing mass in pancreatic head suggesting hypervascular pancreatic mass lesion. Examination and immunohistochemical staining of the tumor revealed well differentiated neuroendocrine carcinoma with extension to duodenal wall and lymph node metastasis.
Conclusion Despite of low incidence, the pediatricians should be aware and consider tumors in differential diagnosis of jaundice in children specifically if prolonged. In addition total anti HAV Ab test for diagnosis of hepatitis A should be discouraged.