ABSTRACT
Nonfunctioning islet cell tumor of the pancreas is mostly malignant and has a poor prognosis. But, even in case of hepatic metastasis, the multimodality treatment including surgical resection, transhepatic arterial chemoembolization(TACE), radiofrequency interstitial tissue ablation(RITA), and systemic chemotherapy provides a better prognosis. We report a case of the multimodality treatment for malignant nonfunctioning islet cell tumor of the pancreas. The patient was 38-year old male whose diagnosis was made by routine health check-up. Abdominal computed tomography revealed about 20cm sized hypervascular mass in the tail of the pancreas. After preoperative selective arterial embolization for the purpose of reducing surgical bleeding, we explored his abdomen and found the mass originating from the tail of the pancreas and expanding to the spleen and transverse colon. We performed distal pancreatectomy combined with total gastrectomy, splenectomy, and transverse colectomy. Also, we found multiple bilobar hepatic metastatic nodules and performed the wedge resection for the lesion of the left lateral segment. Postoperatively, we underwent the TACE and the RITA for the remaining right hepatic metastatic nodules, then performed the systemic chemotherapy with interferon-alpha. At postoperative 22 months, the patient was alive with regular follow up of viable right hepatic metastatic nodules.