Wang Ke, Si Chengshuai, Shao Peng, Cao Yuepeng, Zhang Jin, Yang Liu
Department of Colorectal Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing 210009, China.
Department of Colorectal Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing 210009, China.
Int J Surg Case Rep. 2024 Dec;125:110624. doi: 10.1016/j.ijscr.2024.110624. Epub 2024 Nov 16.
Reports of rectal neuroendocrine tumor (R-NET) are relatively rare. There is a lack of experience in how to accurately locate and resect metastatic lateral lymph nodes.
We present a challenging case. The patient was diagnosed with rectal neuroendocrine tumor. After endoscopic submucosal dissection (ESD), this patient came to hospital for reexamination. The imaging results indicated the presence of left lateral lymph node metastasis, so total mesorectal excision (TME) plus lateral lymph node dissection(LLND) was performed. One year later, PET-CT was reexamined again, using a contrast agent targeted at somatostatin receptor. The result showed residual metastatic lymph nodes. We used nanocarbon combined with coil to accurately locate the metastatic lymph nodes and finally successfully resected the lymph node. The patient recovered and was discharged 5 days after the operation.
Surgery is the most effective method for treating rectal neuroendocrine tumors. However, it is still challenging to accurately detect and locate metastatic lymph nodes after surgery. 68Ga-DOTA-NOC is a special contrast agent that targets somatostatin receptors, and somatostatin receptors are highly expressed in NETs. Using it can clearly trace whether the lateral lymph nodes are metastasized. Nanocarbon localization has been used for the localization of various tumors. We combined it with coils and effectively located the metastatic lymph nodes. This localization method has great potential.
Surgical resection is the most effective way to treat rectal neuroendocrine tumors. Nanocarbon combined with coils can effectively locate metastatic lymph nodes, which is helpful for accurate resection later. And 68Ga-DOTA-NOC can assist in detection of metastatic lymph nodes.
直肠神经内分泌肿瘤（R-NET）的报道相对较少。在如何准确定位和切除转移性侧方淋巴结方面缺乏经验。
我们呈现一个具有挑战性的病例。该患者被诊断为直肠神经内分泌肿瘤。在内镜下黏膜下剥离术（ESD）后，该患者前来医院复查。影像学结果显示存在左侧淋巴结转移，因此进行了全直肠系膜切除术（TME）加侧方淋巴结清扫术（LLND）。一年后，再次进行PET-CT复查，使用靶向生长抑素受体的造影剂。结果显示有残留的转移性淋巴结。我们使用纳米碳联合线圈准确地定位了转移性淋巴结，最终成功切除了该淋巴结。患者术后恢复良好，术后5天出院。
手术是治疗直肠神经内分泌肿瘤最有效的方法。然而，术后准确检测和定位转移性淋巴结仍然具有挑战性。68Ga-DOTA-NOC是一种靶向生长抑素受体的特殊造影剂，生长抑素受体在神经内分泌肿瘤中高度表达。使用它可以清晰地追踪侧方淋巴结是否转移。纳米碳定位已被用于各种肿瘤的定位。我们将其与线圈联合，有效地定位了转移性淋巴结。这种定位方法具有很大的潜力。
手术切除是治疗直肠神经内分泌肿瘤最有效的方法。纳米碳联合线圈可以有效地定位转移性淋巴结，这有助于后续的精确切除。并且68Ga-DOTA-NOC可以辅助检测转移性淋巴结。
