Hane Yuma, Tsuchikawa Takahiro, Takeuchi Satoshi, Tanaka Kimitaka, Nakanishi Yoshitsugu, Asano Toshimichi, Noji Takehiro, Kurashima Yo, Ebihara Yuma, Murakami Soichi, Nakamura Toru, Okamura Keisuke, Shichinohe Toshiaki, Hirano Satoshi
Department of Gastroenterological Surgery II, Division of Surgery, Hokkaido University Faculty of Medicine, Sapporo 060-8638, Japan.
Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.
J Surg Case Rep. 2021 Oct 13;2021(10):rjab446. doi: 10.1093/jscr/rjab446. eCollection 2021 Oct.
Pancreatic neuroendocrine neoplasms (PNENs) are rare, but their incidence has increased in recent years. Curative surgery is recommended in several global guidelines for resectable PNENs. Lymph node recurrence after R0 resection for PNENs is infrequent, and global guidelines recommend surgical resection for recurrence, if resectable. However, data on the prognosis after surgical resection for nodal recurrence of PNENs are limited. We herein report two cases in which long-term survival was achieved after repetitive lymphadenectomy for nodal recurrence of PNENs. In both cases, the pathological findings for primary PNEN showed well-differentiated neuroendocrine neoplasms and R0 resection was successfully performed. The Ki-67 index increased with each resection in both cases. Both patients showed long-term survival (10 and 14 years, respectively). Repetitive lymphadenectomy for nodal recurrence of PNENs may improve patient prognosis.
胰腺神经内分泌肿瘤（PNENs）较为罕见，但近年来其发病率有所上升。多项全球指南推荐对可切除的PNENs进行根治性手术。PNENs行R0切除术后淋巴结复发并不常见，全球指南建议，若复发灶可切除，则对其进行手术切除。然而，关于PNENs淋巴结复发手术切除后的预后数据有限。我们在此报告两例PNENs淋巴结复发经反复淋巴结清扫后实现长期生存的病例。两例患者的原发性PNENs病理结果均显示为高分化神经内分泌肿瘤，且均成功进行了R0切除。两例患者每次切除后Ki-67指数均升高。两名患者均实现了长期生存（分别为10年和14年）。PNENs淋巴结复发的反复淋巴结清扫可能改善患者预后。
