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Oligosymptomatic neuroendocrine neoplasm of small intestine with metastases spread to heart, bones, muscles and intraperitoneally after few years in remission – diagnostic and therapeutic difficulties
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Abstract
Fifty-one years old male patient with the history of recurring abdominal pains and signs of subileus, without carcinoid syndrome signs, underwent laparatomy with the resection of small intestine segment. Histopathology revealed well-differentiated neuroendocrine neoplasm of the small intestine. Due to the lack of hormonal activity and low malignancy potential the patient was not qualified for adjuvant therapy. Computed tomography performed once a year did not indicate the recurrence of the neoplasm. Patient did not report any “red flag” symptoms. After few years in remission [68Ga]-DOTATE PET/CT revealed dynamic development of the illness. Patient was qualified for palliative treatment with long-acting somatostatin analogue. Due to the treatment’s ineffectiveness and further progression of the disease patient received Peptide Receptor Radionuclide Therapy (PRRT). In spite of the therapy his condition did not improve and progression was observed. Patient died because of malfunction of cardiac conduction system caused by the metastases in the heart.
Abstract
Fifty-one years old male patient with the history of recurring abdominal pains and signs of subileus, without carcinoid syndrome signs, underwent laparatomy with the resection of small intestine segment. Histopathology revealed well-differentiated neuroendocrine neoplasm of the small intestine. Due to the lack of hormonal activity and low malignancy potential the patient was not qualified for adjuvant therapy. Computed tomography performed once a year did not indicate the recurrence of the neoplasm. Patient did not report any “red flag” symptoms. After few years in remission [68Ga]-DOTATE PET/CT revealed dynamic development of the illness. Patient was qualified for palliative treatment with long-acting somatostatin analogue. Due to the treatment’s ineffectiveness and further progression of the disease patient received Peptide Receptor Radionuclide Therapy (PRRT). In spite of the therapy his condition did not improve and progression was observed. Patient died because of malfunction of cardiac conduction system caused by the metastases in the heart.
Keywords
neuroendocrine neoplasm; carcinoid syndrome; somatostatin analogue; radioisotope therapy
About this articleTitle
Oligosymptomatic neuroendocrine neoplasm of small intestine with metastases spread to heart, bones, muscles and intraperitoneally after few years in remission – diagnostic and therapeutic difficulties
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Case report
Published online
2021-01-25
DOI
10.5603/NJO.a2021.0002
Keywords
neuroendocrine neoplasm
carcinoid syndrome
somatostatin analogue
radioisotope therapy
Authors
Natalia Tyrybon
Agnieszka Żyłka
Joanna Długosińska
Małgorzata Benke
Marek Dedecjus
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