A Case of a Metastatic Pancreatic Neuroendocrine Tumor: A Surgical Conundrum Wrapped in Functionality's Embrace

This case study reports a rare case of a non-functioning metastatic pancreatic neuroendocrine tumor (pNET) transforming into a functioning pNET. A 59-year-old male, previously treated with distal pancreatectomy, splenectomy, lymph node dissection, liver metastasectomy, and pharmacotherapy, presented...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-03, Vol.16 (3), p.e56893
Main Authors: Mylonakis, Adam, Vailas, Michail, Sakarellos, Panagiotis, Karydakis, Lysandros, Kyros, Eleandros, Davakis, Spyridon, Papalampros, Alexandros, Felekouras, Evaggelos
Format: Article
Language:English
Subjects:
Abdomen
Ablation
Biopsy
Case reports
Diarrhea
Endocrinology/Diabetes/Metabolism
General Surgery
Hepatectomy
Hormones
Hypoglycemia
Liver cancer
Liver diseases
Lymphatic system
Magnetic resonance imaging
Metastasis
Neuroendocrine tumors
Oncology
Pancreatic cancer
Patients
Peptides
Radiation therapy
Thyroid gland
Tomography
Ultrasonic imaging
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Summary:This case study reports a rare case of a non-functioning metastatic pancreatic neuroendocrine tumor (pNET) transforming into a functioning pNET. A 59-year-old male, previously treated with distal pancreatectomy, splenectomy, lymph node dissection, liver metastasectomy, and pharmacotherapy, presented with weakness, hypoglycemia, and daily episodes of watery diarrhea. A functioning neuroendocrine liver metastasis expressing insulin and gastrin was identified. Surgical intervention, including left lateral hepatectomy and microwave ablation of multiple intrahepatic lesions, resulted in symptom resolution and uneventful recovery. However, metastatic liver disease re-emerged seven months post-surgery, necessitating chemotherapy. This case highlights the importance of vigilance for symptom development in non-functioning pNETs, signaling potential disease relapse and phenotype transformation, and suggests surgical treatment as a viable option in select cases.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.56893