SFC, female, 41 years old, white. No tobacco or alcohol use. with no relevant past medical history, She underwent a laparoscopic Roux-en-Y gastric bypass for morbid obesity in 2002. She presented to our emergency department with acute upper abdominal pain, radiating from the flanks, and after medical evolution, the hypothesis of renal colic was done. An IV contrast-enhanced CT scan showed right urolithiasis and the presence of a well-defined tumor of body and neck of pancreas. She denied weight loss or diarrhea and had no jaundice. Therapeutic approaches for the treatment of renal colic in the emergency department were done and after completely resolve it, patient was referred for outpatient treatment. MRI scans showed the presence of a well-defined cystic tumor arising from the pancreatic body and neck with 6 cm of greater diameter. The surgery was performed with the patient in the supine and 45° anti-Trendelenburg position with the surgeon standing between the patient's legs. Four trocars (Two 5-mm, one 12-mm and one 10-mm trocars) were inserted into the upper abdominal quadrant. Adhesions between the posterior wall of stomach, pre-colic and pre-gastric alimentary limb with pancreas are released completely. After tumor be resected, distal pancreatic stump was anastomosed to excluded stomach, in distal body, intracorporeally. We used a double layer invaginated pancreatogastrostomy using low-absorbable monofilament single sutures. There was no pancreatic fistula and the drain was removed on the 4th pos-op day, when she was discharged. Immunohistochemical analysis conclusion was: A lower tumor grade pancreatic neuroendocrine tumor.