Division of Endocrinology, Department of Pathophysiology and Endocrinology, Silesian Medical University, ul. Ceglana 35, Katowice, Poland.
Endokrynol Pol. 2012;63(1):59-64.
We present the diagnostic and therapeutic difficulties encountered in a patient with a clinically advanced pancreatic neuroendocrine tumour. The report concerns a 60-year-old female patient with the diagnosis of non-functioning pancreatic neuroendocrine tumour (NET G1) with liver, peripancreatic lymph node and mediastinal metastases. Due to the presence of advanced disease (inoperable pancreatic tumour, presence of multiple metastases) the patient was considered ineligible for surgical treatment on two occasions. Tissue samples for histopathology were collected during an exploratory laparotomy, which made it possible to establish the diagnosis. As somatostatin receptor scintigraphy was positive, the patient was started on somatostatin analogues and radionuclide therapy was initiated, resulting in satisfactory response in the form of complete remission of liver metastases and the decreased size of the primary tumour in the pancreas. The use of somatostatin analogues in the case of an inoperable neuroendocrine tumour which was assessed as clinically advanced, yet possessing a low proliferative potential, is a promising therapeutic option.
我们介绍了一位临床晚期胰腺神经内分泌肿瘤患者所遇到的诊断和治疗困难。该报告涉及一位 60 岁女性患者，临床诊断为无功能性胰腺神经内分泌肿瘤（NET G1），伴有肝、胰周淋巴结和纵隔转移。由于疾病处于晚期（胰腺肿瘤不可切除，存在多处转移），该患者两次被认为不适合手术治疗。在剖腹探查期间采集了组织样本进行组织病理学检查，从而能够明确诊断。由于生长抑素受体闪烁显像阳性，该患者开始使用生长抑素类似物，并开始进行放射性核素治疗，结果肝脏转移完全缓解，胰腺原发肿瘤体积缩小，疗效令人满意。对于临床评估为晚期但增殖潜能较低的不可切除神经内分泌肿瘤，使用生长抑素类似物是一种有前途的治疗选择。
