Management of incidental pancreatic neuroendocrine tumor: a case report with literature review.

IF 0.9 4区医学 Q3 SURGERY Annali italiani di chirurgia Pub Date : 2023-11-13

Erasmo Spaziani, Annalisa Romina Di Filippo, Martina Spaziani, Giovanni Traumueller Tamagnini, Piero Francioni, Nello Salesi, Marcello Picchio, Alessandro De Cesare

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Abstract

Background: Pancreatic neuroendocrine tumors (PNETs) are rare and accounting for less than 5% of all pancreatic neoplasms. Their management depends on dimension of the lesion, main pancreatic duct (MPD) caliber, tumor malignancy features and evolutive potential.

Case report: Incidental finding of a lesion 1.2 cm wide of the pancreatic body, after contrast enhanced total body CT, in a 71 years old obese Caucasian male (BMI>25), during follow-up for cutaneous melanoma. The lesion was confirmed by MRI and 68-Ga pancreatic scintigraphy. EUS showed a second hypoecogenic and hypovascularized lesion compatible with pancreatic tail PNET. After FNB, Ki-67 was below 3%.

Discussion: 68-Gallium PET-CT was the preferred technique for the staging of the neuroendocrine neoplasm, for treatment planning, for the localization of the pancreatic lesion, excluding the presence of unknown extra-pancreatic lesions. EUS-FNB is indicated in patient with suspicion of PNET, although further investigation is needed to include it as a routine diagnostic examination.

Conclusion: Surgery is mandatory in case of PNETs larger than 2 cm, with MPD dilation, Ki-67>20% and compression symptoms.

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偶发胰腺神经内分泌肿瘤的处理：病例报告与文献综述。

背景：胰腺神经内分泌肿瘤（PNETs）非常罕见，在所有胰腺肿瘤中占比不到 5%。其治疗取决于病变的大小、主胰管（MPD）口径、肿瘤恶性特征和演变潜力：病例报告：一名 71 岁的肥胖白种男性（BMI>25）在接受皮肤黑色素瘤随访期间，经造影剂增强全身 CT 检查后意外发现胰腺体有 1.2 厘米宽的病变。病灶经核磁共振成像和 68-Ga 胰腺闪烁扫描证实。EUS 显示第二个低胰液生成和低血管化病灶，与胰尾 PNET 相符。讨论：68-镓PET-CT是神经内分泌肿瘤分期、治疗计划、胰腺病变定位、排除未知胰腺外病变的首选技术。EUS-FNB适用于怀疑患有PNET的患者，但将其作为常规诊断检查还需进一步研究：结论：PNET大于2厘米、MPD扩张、Ki-67>20%且伴有压迫症状时，必须进行手术治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annali italiani di chirurgia 医学-外科

CiteScore

0.90

自引率

12.50%

发文量

116

审稿时长

>12 weeks

期刊介绍： Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.