• Zongming Zhang, Limin Liu, Youwei Li, Zhuo Liu, Chong Zhang, Yue Zhao, Mingwen Zhu, Baijiang Wan, Hai Deng, Xiyuan Xie, Kun Tian, Zhentian Guo, Haiyan Yang, Jiahong Liao, Hongyan Zhu, Lili Liu, Man Wang, Xiaoting Ma, Tiantian Liu, Niuniu Huang, Yujiao Gao, Jing Zhao, Fang Liao, Fengyuan Li, Xueting Wang, Ruijiao Yuan, Xinying Liu, and Lidan Chang.
• Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing 100073, China.
• Medicine (Baltimore). 2022 Sep 2; 101 (35): e30323.

RationalePancreatic mixed serous neuroendocrine neoplasm (PMSNN) is an extremely rare disease. Only a few cases on the surgical treatment of PMSNN have been reported in the literature, and it is unclear whether there is invasion of important peripancreatic vessels.Patient ConcernsWe report the case of a 39-year-old female patient with PMSNN accompanied by invasion of important peripancreatic vessels. She underwent surgery and achieved satisfactory recovery.DiagnosisAbdominal enhanced CT images showed an enhanced mass with a nonenhanced cyst involving the head and body of the pancreas, which invaded important peripancreatic vessels. The lesion had been misdiagnosed and mistreated as a metastatic carcinoma before admission.InterventionsCT 3-dimensional (3D) visualization reconstruction images showed intact peripancreatic vessels. Radical pancreatoduodenectomy was successfully performed and confirmed that the main blood vessels around the pancreas were only compressed or even wrapped by the mass, but not penetrated.OutcomesThe patient recovered well and was discharged on the 19th day after surgery. Pathological examination reported the diagnosis of PMSNN with the collision type combination and the well-differentiated grade 2 pancreatic neuroendocrine tumor. She was followed up for 18 months without any abnormalities.LessonsThis case demonstrates that surgical treatment of PMSNN with invasion of peripancreatic vessels can be successful. Preoperative abdominal CT 3D visualization reconstruction is helpful in determining the degree of invasion of important peripancreatic vessels, and plays a key role in formulating an accurate surgical plan and improving patient outcome.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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