Figure 1: CT sections showing pancreatic tumor, upstream pancreatic atrophy and hepatic metastasis.

Anatomopathology report of the CT guided biopsy showed a largely necrotic carcinomatous proliferation organized in trabecular structures. Tumor cells were rounded or polyhedral, with an eosinophilic cytoplasm, large vesicular nuclei and highly irregular nuclear contours. On immunohistochemical analysis, tumor cells stained diffusely for chromogranin and synaptophysin. The Ki67 showed a proliferative index of 30 % confirming the diagnosis of a pancreatic neuroendocrine carcinoma (figure2).