Atypical presentation and diagnosis of a metastatic grade II pancreatic neuroendocrine tumor in a 52‑year‑old female patient: A case report

Pancreatic neuroendocrine tumors (PanNETs) are rare malignant neoplasms characterized by slow growth and variable clinical presentation. Although some secrete functional hormones, the majority remain clinically silent or manifest with non-specific symptoms, posing a challenge to early diagnosis. The present study describes the case of a 52-year-old female patient with a significant family history of malignancy, who presented with a syncopal episode following months of weight loss, fatigue and vague abdominal symptoms. A diagnostic workup revealed severe anemia and imaging findings consistent with metastatic disease. A computed tomogrpaphy-guided liver biopsy confirmed a moderately differentiated, grade II neuroendocrine tumor. Treatment with intramuscular octreotide was initiated, and the patient was discharged under palliative care. The case described herein underscores the clinical complexity and often subtle nature of PanNETs, and highlights the importance of considering them in the differential diagnosis of persistent constitutional symptoms, particularly in high-risk individuals. Timely diagnosis supported by histopathology and immunohistochemistry, combined with access to targeted therapies, is essential to improve the outcomes of patients. The integration of molecular screening and emerging therapeutic targets may transform the management of PanNETs, enabling earlier and more personalized interventions in the near future.