LAUSR

Neuroendocrine tumors (NET) are rare, indolent tumors originating most commonly in the small intestine, followed by pancreas and lung. Diagnosis and staging of these tumors can be notoriously difficult due to unpredictable tumor localization and nonspecific array of potential hormonal side effects. Chylous ascites is a rare form of ascites that is characterized by a milky-white appearance and a triglyceride content greater than 200 mg/dL. We present the case of an elderly man presenting with chronic diarrhea and dyspnea, originally thought to have metastatic cancer with malignant ascites. Our report illustrates the thoughtful multidisciplinary workup that led to the diagnosis of chylous ascites occurring as a rare complication of pancreatic NET compression of the pancreatic duct, including paracentesis fluid studies and the role of specialized somatostatin scans. This case highlights the importance of perseverant workup and patient advocacy as it can affect the prognostication and management of NET.