An atypical course of pancreatic neuroendocrine tumour manifesting as cardiac metastasis — a clinical case

Abstract

This paper presents a ten-year course of the disease in a patient with pancreatic neuroendocrine tumour NEN G1, and with confirmed single, asymptomatic metastasis to the left cardiac ventricle. Initially, the cardiac metastasis was visible only on a positron emission tomography (PET) scan using gallium-68-labelled somatostatin analogue; the sensitivity of an echocardiography scan was lower. Despite the advanced stage of the disease, surgical excision of the cardiac metastasis was performed. The patient underwent a total of eight operations, and received chemotherapy, radiotherapy and somatostatin analogues. Currently, he is on a targeted therapy with everolimus. As a result of the treatment, the patient remains in a good general condition. This is the second described case of cardiac metastasis of PNEN. Using different methods of treatment in the case of generalised pancreatic neuroendocrine tumour with low proliferative potential, patients are offered the chance to prolong their survival and maintain a good quality of life.