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Case Reports in Medicine
Volume 2011, Article ID 309149, 4 pages
Case Report

Unusual Paraneoplastic Syndrome Accompanies Neuroendocrine Tumours of the Pancreas

1Endoscopia Digestiva, Nuovo Ospedale Civile S. Agostino-Estense, Via Giardini 1355, 41100 Modena, Italy
2Centro Trapianti di Fegato e Multiviscerale, Università di Modena e Reggio Emilia, Italy
3Neurologia, Nuovo Ospedale Civile S. Agostino Estense, Modena, Italy
4Anatomia Patologica, Università di Modena e Reggio Emilia, Italy

Received 8 October 2010; Accepted 11 March 2011

Academic Editor: Tobias Keck

Copyright © 2011 Helga Bertani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Neuroendocrine tumours comprise a small percentage of pancreatic neoplasia (10%) (1). Diagnosis of neuroendocrine tumours is difficult, especially if the tumours are small and nonfunctional. CT scans, MRI, and nuclear scans are sufficiently sensitive assessment tools for tumours with diameters of at least 2 cm; otherwise, the sensitivity and specificity of these techniques is less than 50% (2). Myasthenia gravis (MG) is a heterogeneous neuromuscular junction disorder that is primarily caused when antibodies form against the acetylcholine receptors (Ab-AchR). MG can develop in conjunction with neoplasia, making MG a paraneoplastic disease. In those cases, MG is most commonly associated with thymomas and less frequently associated with extrathymic malignancies. The mechanism underlying this paraneoplastic syndrome has been hypothesized to involve an autoimmune response against the tumour cells (3). No published reports have linked malignant pancreatic diseases with MG. Here, we report the case of a young woman, negative for Ab-AchR, with a neuroendocrine tumour in the pancreatic head, who experienced a complete resolution of her MG-like syndrome after surgical enucleation of the tumour.