Rayes Ramsey, Partovi Omeed, Strohbeen Stephanie, Bureau Britta L, Giorgadze Tamara, Mostafa Mohamed, Asmi Nisar
Internal Medicine, Medical College of Wisconsin, Wauwatosa, USA.
Neurology, Medical College of Wisconsin, Wauwatosa, USA.
Cureus. 2024 Jan 22;16(1):e52729. doi: 10.7759/cureus.52729. eCollection 2024 Jan.
Neuroendocrine tumors (NETs) are a rare subset of malignancies in the biliary tract that may have an aggressive and initially asymptomatic course. A 93-year-old female presented with four days of abdominal pain with associated nausea, jaundice, and brown-colored urine. A CT scan revealed a soft-tissue lesion measuring 1.9 x 1.5 x 1.9 cm within the distal-most aspect of the common bile duct and papilla with marked bile duct dilatation, pancreatic duct dilatation, and multiple hepatic lesions of varying sizes. The biliary stricture was palliated with a stent via endoscopic retrograde cholangiopancreatography. Biopsies taken from the biliary mass were consistent with a well-differentiated NET: World Health Organization, Grade 3. The patient was minimally symptomatic after stenting and was discharged home. She ultimately decided not to pursue further treatment and passed away two months after the initial presentation. Currently, surgical excision is considered the main and only curative treatment for localized NETs, although chemotherapy and radiation therapy may be suitable. Early detection and treatment of these rare NETs in the biliary tree can potentially result in curative treatment.
神经内分泌肿瘤（NETs）是胆道恶性肿瘤中罕见的一类，其病程可能呈侵袭性且起初无症状。一名93岁女性因腹痛4天就诊，伴有恶心、黄疸和茶色尿。CT扫描显示在胆总管最远端和乳头处有一个大小为1.9×1.5×1.9 cm的软组织病变，伴有明显的胆管扩张、胰管扩张以及多个大小不一的肝脏病变。通过内镜逆行胰胆管造影术置入支架缓解了胆道狭窄。取自胆道肿物的活检结果符合高分化NET：世界卫生组织3级。置入支架后患者症状轻微，随后出院。她最终决定不接受进一步治疗，在初次就诊两个月后去世。目前，手术切除被认为是局限性NETs的主要且唯一的根治性治疗方法，尽管化疗和放疗可能也适用。早期发现并治疗胆道系统中这些罕见的NETs有可能实现根治性治疗。
