adjuvant therapy who underwent RP were included. The median age was 64.7 years, the median preoperative PSA level was 7.9 ng/ mL, and the median follow-up was 5.2 years. We analysed pathological tumour stage, grading, number and location of PSMs, PSAfree survival, local recurrence-free survival, metastasis-free survival, prostate cancerspecific and, overall survival prospectively. RESULTSThe overall rate of PSMs was 17.2%. The number was higher in higher stage ( P < 0.001) and higher grade tumours ( P = 0.041). For a PSM the PSA recurrence rate was 64.3%, the local recurrence rate was 18.6%, the development of distant metastasis was 15.7% and therefore much higher than in patients with negative margins (20.5%, 2.7%, and 1.5%). A PSM was an adverse predictor for PSA-free survival ( P < 0.001), local recurrence-free survival ( P = 0.002), and development of metastasis ( P = 0.003) on multivariate analysis. The number and location of PSMs was of no additional prognostic value. CONCLUSIONS

IntroductionMetastasized pancreatic neuroendocrine tumors are extremely rare malignancies, especially in children. Therefore, therapeutic options are limited, and few standardized therapy regimens exist.Case presentationWe report a case of a 14-year-old white girl. In 2011 she was diagnosed with a metastasized, well-differentiated pancreatic neuroendocrine tumor with expression of synaptophysin and chromogranin A. We describe her clinical course with special attention to her individual therapeutic regimens while bringing together several disciplines of medicine.ConclusionsIn patients such as ours, surgical intervention may be the only therapy that will lead to long-term survival.

No abstract