Akiyama Takahiro, Yoshitomi Hideyuki, Shida Takashi, Shimizu Hiroaki, Ohtsuka Masayuki, Kato Atsushi, Furukawa Katsunori, Takayashiki Tsukasa, Kuboki Satoshi, Takano Shigetsugu, Okamura Daiki, Suzuki Daisuke, Sakai Nozomu, Kagawa Shingo, Miyazaki Masaru
Dept. of General Surgery, Graduate School of Medicine, Chiba University.
Gan To Kagaku Ryoho. 2015 Nov;42(12):2397-9.
We report 2 cases of pancreatic neuroendocrine tumor with liver metastases successfully treated with multidisciplinary therapy, including multiple surgical resections. Case 1: A 63-year-old man underwent distal pancreatectomy and portal vein resection for a pancreatic body tumor. Histological analysis revealed the tumor was a pancreatic neuroendocrine tumor (p-NET), classified as NET G2. His metachronous liver metastases were treated with lateral sectionectomy and 2 rounds of transcatheter arterial chemoembolization (TACE). He is being treated with everolimus for para-aortic lymph node metastases and is alive 90 months after the primary operation. Case 2: A 64-year-old man underwent distal gastrectomy for a duodenal ulcer and distal pancreatectomy for a pancreatic tumor. The histological diagnosis was gastrinoma classified as NET G2. Hepatectomy (segmentectomy of segment 8 and partial hepatectomy) was performed twice for metachronous liver metastases. Everolimus has been administered for liver and para-aortic lymph node metastases, and the patient is alive 108 months after the primary operation.
Multidisciplinary treatment should be considered for patients with p-NETs with multiple metastases.
我们报告2例胰腺神经内分泌肿瘤伴肝转移患者经多学科治疗成功治愈,包括多次手术切除。病例1:一名63岁男性因胰体部肿瘤接受了胰体尾切除术和门静脉切除术。组织学分析显示肿瘤为胰腺神经内分泌肿瘤(p-NET),分类为NET G2。其异时性肝转移采用肝左外叶切除术和2轮经动脉化疗栓塞术(TACE)治疗。他因腹主动脉旁淋巴结转移正在接受依维莫司治疗,初次手术后存活90个月。病例2:一名64岁男性因十二指肠溃疡接受了远端胃切除术,因胰腺肿瘤接受了胰体尾切除术。组织学诊断为胃泌素瘤,分类为NET G2。因异时性肝转移进行了两次肝切除术(肝段8段切除术和部分肝切除术)。已对肝转移和腹主动脉旁淋巴结转移给予依维莫司治疗,患者初次手术后存活108个月。
对于多发转移的p-NET患者应考虑多学科治疗。