Yıldırım Ülkü Miray, Koca Dilşad, Kebudi Rejin
Division of Pediatric Hematology Oncology, Institute of Oncology, İstanbul University, İstanbul, Türkiye.
Turk J Pediatr. 2024 Jul 11;66(3):332-339. doi: 10.24953/turkjpediatr.2024.4526.
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare in children and adolescents. Standard management of these tumors has not been well established due to their rarity in this age group. We aimed to report the clinical and pathological characteristics of patients with this rare disease followed and treated between the years 1993-2022.
The medical records of patients with GEP-NETs were reviewed.
Fourteen patients (11 girls, 3 boys) were diagnosed with GEP-NET. The median age was 13 (9-18) years. Tumor localization was the appendix in 12, stomach in one and pancreas in one patient. Mesoappendix invasion was detected in four patients two of whom underwent right hemicolectomy (RHC) and lymph node dissection (LND). Of those, one patient had lymph node involvement. The other two had not further operations. Somatostatin was used in one with pancreatic metastatic disease and the other with gastric disease after surgery. No additional treatment was given in other patients. All patients are under follow-up without evidence of disease at a median follow-up of 85 months (7-226 months).
GEP-NETs should be considered in the differential diagnosis of acute appendicitis and in cases with persistent abdominal pain. In children, there is invariably a favorable prognosis, and additional surgical interventions other than simple appendectomies generally do not provide benefits. Mesoappendix invasion may not necessitate RHC and LND.
胃肠胰神经内分泌肿瘤(GEP-NETs)在儿童和青少年中较为罕见。由于该肿瘤在这一年龄组中罕见,其标准治疗方案尚未完全确立。我们旨在报告1993年至2022年间随访和治疗的这种罕见疾病患者的临床和病理特征。
回顾了GEP-NETs患者的病历。
14例患者(11例女孩,3例男孩)被诊断为GEP-NETs。中位年龄为13岁(9-18岁)。肿瘤定位:12例位于阑尾,1例位于胃,1例位于胰腺。4例患者检测到阑尾系膜侵犯,其中2例接受了右半结肠切除术(RHC)和淋巴结清扫术(LND)。其中1例患者有淋巴结受累。另外2例未进一步手术。1例胰腺转移疾病患者和另1例术后胃部疾病患者使用了生长抑素。其他患者未给予额外治疗。所有患者均在随访中,中位随访85个月(7-226个月),无疾病证据。
在急性阑尾炎的鉴别诊断和持续性腹痛病例中应考虑GEP-NETs。在儿童中,预后通常良好,除单纯阑尾切除术外的其他手术干预一般无益处。阑尾系膜侵犯可能不需要RHC和LND。