Spontaneous intra-abdominal hemorrhage of a well-differentiated, grade 3 gastric neuroendocrine tumor during drug-based treatment

Namikawa, Tsutomu; Yokota, Keiichiro; Yamaguchi, Sachi; Fukudome, Ian; Munekage, Masaya; Uemura, Sunao; Maeda, Hiromichi; Kitagawa, Hiroyuki; Mibu, Kiyo; Kobayashi, Mariko; Hanazaki, Kazuhiro

doi:10.1007/s12328-021-01433-3

Cited by 2 publications

(1 citation statement)

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“…presented a case of gastric NET that developed hepatic metastasis (diameter up to 25 cm). Spontaneous rupture of hepatic metastasis was noted 8 months after initial treatment with everolimus plus somatostatin ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Adaptive Tomotherapy for locally advanced unresectable pancreatic neuroendocrine tumor: Case report and literature review

Huang

Lau

et al. 2022

Front. Oncol.

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BackgroundPancreatic neuroendocrine tumor (NET) is rare, and the majority presents late in their clinical course. Here, we present a huge locally advanced pancreatic NET having Hi-Art helical Tomotherapy that resulted in a 68% reduction in target volume during adaptive image-guided radiotherapy (IGRT).Case summaryA 63-year-old man without any history of systemic disease developed voiding difficulty for several months. Associated symptoms included poor appetite, nausea, distended abdomen, and body weight loss. Further magnetic resonance imaging showed a large multilobulated tumor in the left upper abdomen. Tumor biopsy revealed well-differentiated, grade 2, neuroendocrine tumor. Complete resection was unattainable. Therefore, Lanreotide was prescribed initially. However, tumor progression up to the greatest diameter of 18 cm was noted on computed tomography 5 months later. Thus, he stopped Lanreotide and commenced on concurrent chemoradiotherapy (CCRT). With a total dose of 70 Gy in 35 fractions, we generated two adaptive treatment plans during the whole course. Laparoscopic subtotal pancreatectomy with spleen preservation was performed after neoadjuvant CCRT. It has been more than 3 years after IGRT, and he remains cancer free and reports no side effects during regular follow-ups.ConclusionTomotherapy caused tumor size reduction and hence facilitated surgical possibility for this originally unresectable pancreatic NET. Neoadjuvant IGRT incorporated with adaptive treatment planning enhanced delivery accuracy. In this case of pancreatic NET resistant to Lanreotide, inter-fractional tumor regression from 1910 to 605 cc (68%) was documented.

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Section: Discussionmentioning

confidence: 99%