Mohamed Yousif, Salih Aya, Suliman Omer, Hamad Ibrahim, Hussein Ahmed
Radiology, University of Khartoum, Khartoum, SDN.
Internal Medicine, University of Khartoum, Khartoum, SDN.
Cureus. 2024 Oct 1;16(10):e70615. doi: 10.7759/cureus.70615. eCollection 2024 Oct.
Neuroendocrine tumors (NETs) encompass a diverse spectrum of neoplasms that can originate from various sites, including the gastrointestinal tract. Brain metastases from neuroendocrine tumors, while rare, present significant clinical challenges. In this case report, we present the unique instance of a 50-year-old female with a history of gastrointestinal neuroendocrine tumor who manifested left-sided weakness, tremors, and recurrent focal convulsions. Initial imaging scans revealed a lesion in the right parietal lobe, which was surgically excised and diagnosed as a metastatic large-cell neuroendocrine carcinoma. Post-surgery, the patient's condition stabilized, but she was subsequently advised to chemotherapy. This case underscores the infrequency of brain metastases in the context of gastrointestinal neuroendocrine tumors, underscoring the need for comprehensive screening in such scenarios. Given the aggressive nature of neuroendocrine carcinomas and their propensity to disseminate to the brain, early detection and intervention are crucial. Our rare case also underscores the importance of distinguishing high-grade neuroendocrine carcinomas, which necessitate intensive management, from less aggressive NETs and other metastatic neoplasms that have different treatment approaches.
神经内分泌肿瘤（NETs）涵盖了多种可起源于包括胃肠道在内的不同部位的肿瘤。神经内分泌肿瘤的脑转移虽然罕见，但却带来了重大的临床挑战。在本病例报告中，我们呈现了一名50岁女性的独特病例，该女性有胃肠道神经内分泌肿瘤病史，表现为左侧肢体无力、震颤和反复发作的局灶性惊厥。最初的影像学扫描显示右顶叶有一个病变，经手术切除并诊断为转移性大细胞神经内分泌癌。术后，患者病情稳定，但随后被建议进行化疗。该病例强调了胃肠道神经内分泌肿瘤发生脑转移的罕见性，突出了在此类情况下进行全面筛查的必要性。鉴于神经内分泌癌的侵袭性及其向脑部扩散的倾向，早期检测和干预至关重要。我们的罕见病例还强调了区分高级别神经内分泌癌的重要性，高级别神经内分泌癌需要强化管理，而与侵袭性较小的NETs以及具有不同治疗方法的其他转移性肿瘤相区分。
