Peiffer S, Cathomas R, Villiger P
Department of General Surgery, Kantonsspital Graubünden, Loestrasse 170, CH-7000 Chur, Switzerland.
Department of Oncology, Kantonsspital Graubünden, Loestrasse 170, CH-7000 Chur, Switzerland.
Int J Surg Case Rep. 2014;5(12):1117-9. doi: 10.1016/j.ijscr.2014.11.004. Epub 2014 Nov 10.
Neuroendocrine tumors of the small intestine represent about half of all small intestine neoplasms. Recurrence after surgery with curative intention is frequently observed but recurrence rate has not yet been described or analyzed sufficiently.
In this case bilocal recurrence 4 years after curative surgery of an ileocoecal neuroendocrine carcinoma was observed in a 64 year old female. Diagnosis and follow-up was carried out as proposed in current ENETS guidelines using somatostatin receptor scintigraphy for primary diagnosis and Ga-DOTATOC-PET/CT in follow-up.
We can confirm that PET/CT for somatostatin receptor imaging shows good sensitivity in detecting neuroendocrine neoplasms and should be preferred for diagnostic, if available. For individual adaptation of follow-up procedures, as far as time intervals and preferred imaging methods are concerned, research on recurrence rate and long term outcome after curative surgery should be extended.
Livelong follow-up after surgical resection of neuroendocrine tumors is necessary and Ga-DOTA/TOC-PET/CT should be the method of choice, if available.
小肠神经内分泌肿瘤约占所有小肠肿瘤的一半。根治性手术后复发较为常见，但复发率尚未得到充分描述或分析。
该病例为一名64岁女性，在回盲部神经内分泌癌根治性手术后4年出现双部位复发。按照当前ENETS指南的建议进行诊断和随访，使用生长抑素受体闪烁扫描进行初步诊断，随访时使用镓- DOTATOC - PET/CT。
我们可以确认，用于生长抑素受体成像的PET/CT在检测神经内分泌肿瘤方面具有良好的敏感性，如有条件，应优先用于诊断。就随访程序的个体化调整而言，涉及时间间隔和首选成像方法，应扩大对根治性手术后复发率和长期预后的研究。
神经内分泌肿瘤手术切除后需要长期随访，如有条件，镓- DOTA/TOC - PET/CT应作为首选方法。
