Case report of a patient with initially inoperable well- differentiated midgut neuroendocrine tumor (WDNT) - PRRT and long-acting somatostatin analogs as the neoadjuvant therapy

2012
journal article
article
dc.abstract.enA 43-year-old man was admitted to Surgery Department because of abdominal pain, vomiting, weight loss and flushes. Computed tomography (CT) examination revealed upper and middle abdomen tumor of about 110 × 110 mm. Histopathological analysis of the tissues obtained during the exploratory laparotomy confirmed WDNT (well-differentiated neuroendocrine tumor according to the WHO classification 2000). The patient received 5 doses of chemotherapy without any response. A positive result of 99mTc- [EDDA/Hynic] Octreotate scintigraphy (SRS) gave the possibility of PRRT (peptide receptor radionuclide therapy). The patient was treated with the total dose of 400 mCi of 90Y-DOTA-TATE. CT performed after the PRRT revealed regression of the tumor size to 72 × 94 mm. A decrease of CgA level and release of symptoms were also observed. Aiming at the removal of the considerable diminished tumor the patient was qualified for the second laparotomy. “Cytoreduction” surgery with partial excision of the tumor was performed. Additionally tumor-affected appendix was removed. The second focus of WDNT (according to the WHO classification 2000) with Ki67 < 1% was found in the appendix. Pathologists confirmed the above-mentioned lesions as independent (an extremely rare clinical situation). The following treatment with long-acting somatostatin analogs and 300 mCi of 90Y-DOTA-TATE resulted in further regression of the tumor size to 25 × 35 mm. Consecutive laparotomy is considered. If complete tumor removal might be achieved is an open question. The above case report shows the efficacy of combined therapy with the use of “hot” and “cold” somatostatin analogs not only in controlling the symptoms of the disease but also in obtaining tumor size regression making surgical intervention possible. Such a neoadjuvant therapy seems to be a promising tool in the management of patients with initially inoperable neuroendocrine tumors.pl
dc.affiliationWydział Lekarski : Klinika Endokrynologiipl
dc.affiliationWydział Lekarski : Zakład Radiologiipl
dc.affiliationWydział Lekarski : Zakład Patomorfologii Klinicznej i Doświadczalnejpl
dc.affiliationWydział Lekarski : Klinika Chirurgii Ogólnej, Onkologicznej i Gastroenterologicznejpl
dc.contributor.authorSowa-Staszczak, Annapl
dc.contributor.authorPach, Dorotapl
dc.contributor.authorStefańska, Agnieszkapl
dc.contributor.authorSzybiński, Piotrpl
dc.contributor.authorKulig, Jan - 130535 pl
dc.contributor.authorTomaszewska, Romana - 133668 pl
dc.contributor.authorChrzan, Robert - 129018 pl
dc.contributor.authorHubalewska-Dydejczyk, Alicja - 129732 pl
dc.date.accession2020-07-06pl
dc.date.accessioned2020-07-06T09:52:44Z
dc.date.available2020-07-06T09:52:44Z
dc.date.issued2012pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.additionalBibliogr. s. 139pl
dc.description.number2pl
dc.description.physical137-139pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume15pl
dc.identifier.eissn1644-4345pl
dc.identifier.issn1506-9680pl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/165226
dc.identifier.weblinkhttps://journals.viamedica.pl/nuclear_medicine_review/article/view/19589/15366pl
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-ND
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.subject.enPRRTpl
dc.subject.enneoadjuvant therapypl
dc.subject.enwell-differentiated neuroendocrine tumorpl
dc.subtypeArticlepl
dc.titleCase report of a patient with initially inoperable well- differentiated midgut neuroendocrine tumor (WDNT) - PRRT and long-acting somatostatin analogs as the neoadjuvant therapypl
dc.title.journalNuclear Medicine Reviewpl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
A 43-year-old man was admitted to Surgery Department because of abdominal pain, vomiting, weight loss and flushes. Computed tomography (CT) examination revealed upper and middle abdomen tumor of about 110 × 110 mm. Histopathological analysis of the tissues obtained during the exploratory laparotomy confirmed WDNT (well-differentiated neuroendocrine tumor according to the WHO classification 2000). The patient received 5 doses of chemotherapy without any response. A positive result of 99mTc- [EDDA/Hynic] Octreotate scintigraphy (SRS) gave the possibility of PRRT (peptide receptor radionuclide therapy). The patient was treated with the total dose of 400 mCi of 90Y-DOTA-TATE. CT performed after the PRRT revealed regression of the tumor size to 72 × 94 mm. A decrease of CgA level and release of symptoms were also observed. Aiming at the removal of the considerable diminished tumor the patient was qualified for the second laparotomy. “Cytoreduction” surgery with partial excision of the tumor was performed. Additionally tumor-affected appendix was removed. The second focus of WDNT (according to the WHO classification 2000) with Ki67 < 1% was found in the appendix. Pathologists confirmed the above-mentioned lesions as independent (an extremely rare clinical situation). The following treatment with long-acting somatostatin analogs and 300 mCi of 90Y-DOTA-TATE resulted in further regression of the tumor size to 25 × 35 mm. Consecutive laparotomy is considered. If complete tumor removal might be achieved is an open question. The above case report shows the efficacy of combined therapy with the use of “hot” and “cold” somatostatin analogs not only in controlling the symptoms of the disease but also in obtaining tumor size regression making surgical intervention possible. Such a neoadjuvant therapy seems to be a promising tool in the management of patients with initially inoperable neuroendocrine tumors.
dc.affiliationpl
Wydział Lekarski : Klinika Endokrynologii
dc.affiliationpl
Wydział Lekarski : Zakład Radiologii
dc.affiliationpl
Wydział Lekarski : Zakład Patomorfologii Klinicznej i Doświadczalnej
dc.affiliationpl
Wydział Lekarski : Klinika Chirurgii Ogólnej, Onkologicznej i Gastroenterologicznej
dc.contributor.authorpl
Sowa-Staszczak, Anna
dc.contributor.authorpl
Pach, Dorota
dc.contributor.authorpl
Stefańska, Agnieszka
dc.contributor.authorpl
Szybiński, Piotr
dc.contributor.authorpl
Kulig, Jan - 130535
dc.contributor.authorpl
Tomaszewska, Romana - 133668
dc.contributor.authorpl
Chrzan, Robert - 129018
dc.contributor.authorpl
Hubalewska-Dydejczyk, Alicja - 129732
dc.date.accessionpl
2020-07-06
dc.date.accessioned
2020-07-06T09:52:44Z
dc.date.available
2020-07-06T09:52:44Z
dc.date.issuedpl
2012
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.additionalpl
Bibliogr. s. 139
dc.description.numberpl
2
dc.description.physicalpl
137-139
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
15
dc.identifier.eissnpl
1644-4345
dc.identifier.issnpl
1506-9680
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/165226
dc.identifier.weblinkpl
https://journals.viamedica.pl/nuclear_medicine_review/article/view/19589/15366
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-ND
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.subject.enpl
PRRT
dc.subject.enpl
neoadjuvant therapy
dc.subject.enpl
well-differentiated neuroendocrine tumor
dc.subtypepl
Article
dc.titlepl
Case report of a patient with initially inoperable well- differentiated midgut neuroendocrine tumor (WDNT) - PRRT and long-acting somatostatin analogs as the neoadjuvant therapy
dc.title.journalpl
Nuclear Medicine Review
dc.typepl
JournalArticle
dspace.entity.type
Publication

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