Sultan Mahmoud, Al Hasan Azad, Khazem Nisreen
Faculty of Medicine Damascus University Damascus Syria.
Clin Case Rep. 2024 Nov 4;12(11):e9545. doi: 10.1002/ccr3.9545. eCollection 2024 Nov.
Pancreatic neuroendocrine tumors (PNETs) are rare and often misdiagnosed due to their vague symptoms and tumor heterogeneity. Early detection using computed tomography (CT) is essential, particularly in regions without access to advanced diagnostic tools like immunohistochemistry and genetic testing.
Neuroendocrine tumors (NETs) are rare tumors in adults and extremely rare in the pediatric population, as pancreatic NETs (pNETs) have an incidence rate of <0.1 per million. We present a case of a 17-year-old female with a liver metastasized pNET. A 17-year-old female with a history of intermittent abdomen-back pain presented to the clinic with severe upper abdominal pain radiating to the shoulder. The routine tests were normal. An ultrasound showed multiple lesions in the liver, which were confirmed by a computed tomography (CT) that uncovered a pancreatic lesion too. A liver biopsy proved it was a metastasized pNET with positive NET markers on IMC staining. The metaiodobenzylguanidine (MIBG) scan flared the liver lesion. The patient was started on Octreotide long-acting release (LAR) 30 mg once monthly. The rarity of these tumors makes their diagnosis difficult, but they should not be omitted and must be considered when there are long-lasting symptoms that are not compatible with common illnesses. These tumors are curable in their early stages.
胰腺神经内分泌肿瘤（PNETs）较为罕见，因其症状模糊且肿瘤具有异质性，常被误诊。使用计算机断层扫描（CT）进行早期检测至关重要，尤其是在无法获得免疫组织化学和基因检测等先进诊断工具的地区。
神经内分泌肿瘤（NETs）在成人中较为罕见，在儿科人群中极为罕见，胰腺神经内分泌肿瘤（pNETs）的发病率低于百万分之一。我们报告一例17岁女性肝转移pNET病例。一名有间歇性腹背部疼痛病史的17岁女性因严重上腹部疼痛放射至肩部就诊。常规检查正常。超声显示肝脏有多个病灶，计算机断层扫描（CT）证实了这一点，同时还发现了胰腺病灶。肝活检证实为肝转移pNET，免疫组化染色显示NET标志物呈阳性。间碘苄胍（MIBG）扫描显示肝脏病灶。患者开始每月一次注射30毫克长效奥曲肽（LAR）。这些肿瘤的罕见性使其诊断困难，但不应被忽视，当出现与常见疾病不符的长期症状时必须予以考虑。这些肿瘤在早期是可治愈的。
