• Hee Jeong Kim, Mi-Hyun Park, and Byungseok Shin.
• Department of Radiology, Dankook University Hospital, Chungnam, Cheonan-si.
• Medicine (Baltimore). 2018 Dec 1; 97 (50): e13616.

RationaleAdenocarcinoma and neuroendocrine tumors are a very rare combination of double primary pancreas tumor.Patient ConcernsA Whipple operation was initially performed on a 64-year-old man to remove an adenocarcinoma. Four years after the operation, surveillance- computed tomography revealed abnormal findings of the pancreas. Recurrent adenocarcinoma and neuroendocrine tumor involving different sites of the remnant pancreas were simultaneously detected and characterized on computed tomography and magnetic resonance imaging.DiagnosesThe patient was diagnosed with recurrent adenocarcinoma and neuroendocrine tumor in the post-operative pancreas.InterventionsRadical pancreatosplenectomy was performed. The patient underwent subsequent chemotherapy and radiotherapy.OutcomesNo tumor recurrence was found during the 5 years of follow-up visits.LessonsThe possibility of multiple primary tumors of different histological origin should be considered when multiple different pancreatic lesions are detected on images. Computed tomography (CT) and magnetic resonance imaging (MRI) play key roles in the management of multiple tumors in the pancreas.

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