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一例伴有类癌综合征的转移性胰腺神经内分泌肿瘤的跌宕历程

A Tumultuous Journey of Metastatic Pancreatic Neuroendocrine Tumor with Carcinoid Syndrome.

作者信息

Giri Somdatta, Kamalanathan Sadishkumar, Raja Kalayarasan, Pandit Nandini, Naik Dukhabandhu, Sahoo Jayaprakash

机构信息

Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

J ASEAN Fed Endocr Soc. 2025 May;40(1):112-116. doi: 10.15605/jafes.040.01.04. Epub 2025 Apr 20.

DOI:10.15605/jafes.040.01.04
PMID:40416488
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12102652/
Abstract

A 25-year-old woman presented with metastatic pancreatic neuroendocrine tumor with carcinoid syndrome. She was refractory to octreotide and did not respond well to chemotherapy. Although surgical debulking remains the primary approach for managing these tumours, it entails inherent risks, including potentially exacerbating carcinoid syndrome. We strategically delivered the one Peptide Receptor Radionuclide Therapy cycle before tumor debulking, a decision that yielded a remarkable response, stabilizing her condition.

摘要

一名25岁女性因转移性胰腺神经内分泌肿瘤伴类癌综合征就诊。她对奥曲肽耐药，化疗效果也不佳。尽管手术减瘤仍是治疗这些肿瘤的主要方法，但该方法存在固有风险，包括可能加剧类癌综合征。我们在肿瘤减瘤前有策略地进行了一个周期的肽受体放射性核素治疗，这一决定产生了显著效果，稳定了她的病情。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/d191bfe3f181/JAFES-40-1-112-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/3b0109bf1fc3/JAFES-40-1-112-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/d6e24f8c7e66/JAFES-40-1-112-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/4d855bf35736/JAFES-40-1-112-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/7c62653eec50/JAFES-40-1-112-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/7d076991db20/JAFES-40-1-112-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/d191bfe3f181/JAFES-40-1-112-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/3b0109bf1fc3/JAFES-40-1-112-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/d6e24f8c7e66/JAFES-40-1-112-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/4d855bf35736/JAFES-40-1-112-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/7c62653eec50/JAFES-40-1-112-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/7d076991db20/JAFES-40-1-112-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0991/12102652/d191bfe3f181/JAFES-40-1-112-g006.jpg

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本文引用的文献

1
Advancements in medical treatment for pancreatic neuroendocrine tumors: A beacon of hope.胰腺神经内分泌肿瘤的医学治疗进展：希望之光。
World J Gastroenterol. 2024 Mar 28;30(12):1670-1675. doi: 10.3748/wjg.v30.i12.1670.
2
European Neuroendocrine Tumor Society 2023 guidance paper for functioning pancreatic neuroendocrine tumour syndromes.欧洲神经内分泌肿瘤学会 2023 年功能性胰腺神经内分泌肿瘤综合征指南
J Neuroendocrinol. 2023 Aug;35(8):e13318. doi: 10.1111/jne.13318. Epub 2023 Aug 14.
3
Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.
胃肠胰神经内分泌肿瘤：ESMO诊断、治疗及随访临床实践指南
Ann Oncol. 2020 Jul;31(7):844-860. doi: 10.1016/j.annonc.2020.03.304. Epub 2020 Apr 6.
4
Peptide receptor radionuclide therapy as neoadjuvant therapy for resectable or potentially resectable pancreatic neuroendocrine neoplasms.肽受体放射性核素治疗作为可切除或潜在可切除胰腺神经内分泌肿瘤的新辅助治疗。
Surgery. 2018 Apr;163(4):761-767. doi: 10.1016/j.surg.2017.11.007. Epub 2017 Dec 25.
5
Resection of the Primary Tumor Followed by Peptide Receptor Radionuclide Therapy as Upfront Strategy for the Treatment of G1-G2 Pancreatic Neuroendocrine Tumors with Unresectable Liver Metastases.对于伴有不可切除肝转移的G1-G2胰腺神经内分泌肿瘤，先行原发性肿瘤切除，随后进行肽受体放射性核素治疗作为一线治疗策略
Ann Surg Oncol. 2016 Dec;23(Suppl 5):981-989. doi: 10.1245/s10434-016-5550-3. Epub 2016 Sep 9.
6
Peptide receptor radionuclide therapy as a potential tool for neoadjuvant therapy in patients with inoperable neuroendocrine tumours (NETs).肽受体放射性核素治疗作为不可切除神经内分泌肿瘤（NETs）新辅助治疗的潜在手段。
Eur J Nucl Med Mol Imaging. 2011 Sep;38(9):1669-74. doi: 10.1007/s00259-011-1835-8. Epub 2011 May 11.
7
The palliative benefit of aggressive surgical intervention for both hepatic and mesenteric metastases from neuroendocrine tumors.积极手术干预对神经内分泌肿瘤肝转移和肠系膜转移的姑息治疗益处。
Surgery. 2008 Oct;144(4):645-51; discussion 651-3. doi: 10.1016/j.surg.2008.06.008.