Phung Don, Khizer Umair, Farhan Mutahir, Saad Bashar
Internal Medicine, University of California Riverside School of Medicine, Riverside, USA.
Internal Medicine, University of California Riverside, Riverside, USA.
Cureus. 2024 Jun 12;16(6):e62234. doi: 10.7759/cureus.62234. eCollection 2024 Jun.
We present a case of a 50-year-old male who initially presented to the clinic with complaints of palpitations, shortness of breath, dizziness, night sweats, headaches with associated intermittent episodes of diarrhea, episodes of flushing, and rash on the upper body. Laboratory testing revealed elevated chromogranin A levels. Initial imaging with computed tomography (CT) of the abdomen and pelvis with contrast was negative for any lesions. However, due to his clinical presentation and high suspicion of a neuroendocrine tumor (NET), a positron emission tomography-CT (PET-CT) scan with Gallium 68-DOTATATE was obtained, confirming and localizing his NET in the neck of the pancreas and the liver. Following confirmation and localization of his tumor, he was referred for surgical evaluation and treatment. Pancreatic neuroendocrine tumors are rare and difficult to diagnose, highlighted by unsuccessful initial efforts to localize and confirm the tumor. This case underscores the importance of clinical suspicion and acumen in diagnosing neuroendocrine tumors. Upcoming imaging modalities of PET-CT scans provide promising avenues to uncover neuroendocrine tumors.
我们报告一例50岁男性患者，其最初因心悸、气短、头晕、盗汗、头痛伴间歇性腹泻、潮红发作及上身皮疹前来诊所就诊。实验室检查显示嗜铬粒蛋白A水平升高。最初的腹部和盆腔增强计算机断层扫描（CT）未发现任何病变。然而，鉴于其临床表现及高度怀疑神经内分泌肿瘤（NET），遂进行了68镓-奥曲肽正电子发射断层扫描-CT（PET-CT），证实其NET位于胰腺颈部和肝脏，并确定了位置。在肿瘤得到确诊和定位后，他被转诊进行手术评估和治疗。胰腺神经内分泌肿瘤罕见且难以诊断，最初定位和确诊肿瘤的努力未成功就凸显了这一点。该病例强调了临床怀疑和敏锐洞察力在诊断神经内分泌肿瘤中的重要性。PET-CT扫描等新兴成像方式为发现神经内分泌肿瘤提供了有前景的途径。
