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腹膜后腔原发性神经内分泌肿瘤:一例罕见病例报告。

Primary neuroendocrine tumor in the retroperitoneal cavity: A rare case report.

作者信息

Nahle Ali Alakbar, Hamdar Hussein, Jawad Ali, Obaied Alahmar Fadi

机构信息

Damascus University, Faculty of Medicine, Damascus, Syria.

Damascus University, Faculty of Medicine, Damascus, Syria.

出版信息

Int J Surg Case Rep. 2023 Aug;109:108506. doi: 10.1016/j.ijscr.2023.108506. Epub 2023 Jul 13.

Abstract

INTRODUCTION AND IMPORTANCE

Neuroendocrine tumors (NETs) are rare malignancies, accounting for a small percentage of gastrointestinal and bronchopulmonary cancers. Retroperitoneal NETs are infrequent and can be primary or metastatic. They are commonly metastatic rather than primary tumors, with primary retroperitoneal NETs being exceptionally rare.

CASE PRESENTATION

A 38-year-old woman presented with left flank pain persisting for one year, which had progressively worsened. Imaging revealed a large retroperitoneal mass exerting pressure on the stomach, spleen, liver, and upper pole of the left kidney. A biopsy of the tumor was done and the results were consistent with NET. The tumor, which measured approximately 19 × 12.5 × 11 cm, was surgically removed, and the pathological findings were consistent with the results of the biopsy prior to the surgery.

CLINICAL DISCUSSION

Neuroendocrine tumors are rare and exhibit diverse characteristics based on location, size, hormone secretion, and metastasis. Retroperitoneal neuroendocrine tumors are typically metastatic and rarely primary. The extremely large size of the tumor in this case highlights the surgical challenges associated with retroperitoneal NETs. Imaging, such as CT and MRI, plays a crucial role in diagnosis.

CONCLUSION

The study emphasizes the need to consider primary NETs as a possible cause of large retroperitoneal masses, especially if the tumor size is significant. Surgical resection is the primary treatment option with generally favorable outcomes. However, the size of the tumor can complicate treatment, and further research is needed to evaluate the effectiveness of postoperative adjuvant therapy and develop therapeutic approaches for recurrent NETs.

摘要

引言与重要性

神经内分泌肿瘤(NETs)是罕见的恶性肿瘤,在胃肠道和支气管肺癌中占比很小。腹膜后NETs较为少见,可为原发性或转移性。它们通常是转移性的而非原发性肿瘤,原发性腹膜后NETs极为罕见。

病例介绍

一名38岁女性因左侧胁腹疼痛持续一年且逐渐加重前来就诊。影像学检查显示一个巨大的腹膜后肿块,对胃、脾、肝和左肾上极产生压迫。对肿瘤进行了活检,结果与NET一致。该肿瘤大小约为19×12.5×11厘米,通过手术切除,病理结果与手术前活检结果一致。

临床讨论

神经内分泌肿瘤罕见,根据位置、大小、激素分泌和转移情况表现出不同特征。腹膜后神经内分泌肿瘤通常是转移性的,很少是原发性的。本病例中肿瘤极大,凸显了腹膜后NETs相关的手术挑战。CT和MRI等影像学检查在诊断中起关键作用。

结论

该研究强调,对于巨大的腹膜后肿块,尤其是肿瘤体积较大时,需要考虑原发性NETs作为可能病因。手术切除是主要治疗选择,总体预后良好。然而,肿瘤大小会使治疗复杂化,并需要进一步研究以评估术后辅助治疗的有效性以及开发复发性NETs的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0912/10384550/8ed772e8b1d3/gr1.jpg

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