PanNET : Grade 3
Case History: 50 y/o male who presented with RUQ abdominal pain, jaundice, dark urine, and fatty stools. Imaging studies revealed a large mass in the head of the pancreas with obstruction of the common bile duct. The resection specimen showed a 4.0 cm pale, yellow-tan mass in the head of the pancreas with areas of hemorrhage and necrosis.
Grade 3 pancreatic neuroendocrine tumors have >20 mitoses/10 HPF and Ki-67 index >20% and usually <55%.