Gastric neuroendocrine neoplasm with late liver metastasis
Gastric neuroendocrine neoplasms (GNENs) are classified into three types according to their aetiology. We present a clinical case of a female patient of 66 years and a well-differentiated (grade 2), type 3 GNEN with late liver metastasis (LM). The patient underwent surgical excision of a gastric les...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2018-08-01
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| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-18-0048 |
| _version_ | 1811230048274874368 |
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| author | Bernardo Marques Raquel G Martins Guilherme Tralhão Joana Couto Sandra Saraiva Henrique Ferrão João Ribeiro Jacinta Santos Teresa Martins Ana Teresa Cadime Fernando Rodrigues |
| author_facet | Bernardo Marques Raquel G Martins Guilherme Tralhão Joana Couto Sandra Saraiva Henrique Ferrão João Ribeiro Jacinta Santos Teresa Martins Ana Teresa Cadime Fernando Rodrigues |
| author_sort | Bernardo Marques |
| collection | DOAJ |
| description | Gastric neuroendocrine neoplasms (GNENs) are classified into three types according to their aetiology. We present a clinical case of a female patient of 66 years and a well-differentiated (grade 2), type 3 GNEN with late liver metastasis (LM). The patient underwent surgical excision of a gastric lesion at 50 years of age, without any type of follow-up. Sixteen years later, she was found to have a neuroendocrine tumour (NET) metastatic to the liver. The histological review of the gastric lesion previously removed confirmed that it was a NET measuring 8 mm, pT1NxMx (Ki67 = 4%). 68Ga-DOTANOC PET/CT reported two LM and a possible pancreatic tumour/gastric adenopathy. Biopsies of the lesion were repeatedly inconclusive. She had a high chromogranin A, normal gastrin levels and negative anti-parietal cell and intrinsic factor antibodies, which is suggestive of type 3 GNEN. She underwent total gastrectomy and liver segmentectomies (segment IV and VII) with proven metastasis in two perigastric lymph nodes and both with hepatic lesions (Ki67 = 5%), yet no evidence of local recurrence. A 68Ga-DOTANOC PET/CT was performed 3 months after surgery, showing no tumour lesions and normalisation of CgA. Two years after surgery, the patient had no evidence of disease. This case illustrates a rare situation, being a type 3, well-differentiated (grade 2) GNEN, with late LM. Despite this, it was possible to perform surgery with curative intent, which is crucial in these cases, as systemic therapies have limited efficacy. We emphasise the need for extended follow-up in these patients. |
| first_indexed | 2024-04-12T10:23:40Z |
| format | Article |
| id | doaj.art-35c65bb048a343df8e73c0c32c038024 |
| institution | Directory Open Access Journal |
| issn | 2052-0573 2052-0573 |
| language | English |
| last_indexed | 2024-04-12T10:23:40Z |
| publishDate | 2018-08-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-35c65bb048a343df8e73c0c32c0380242022-12-22T03:37:02ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732018-08-01111510.1530/EDM-18-0048Gastric neuroendocrine neoplasm with late liver metastasisBernardo Marques0Raquel G Martins1Guilherme Tralhão2Joana Couto3Sandra Saraiva4Henrique Ferrão5João Ribeiro6Jacinta Santos7Teresa Martins8Ana Teresa Cadime9Fernando Rodrigues10Endocrinology Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalEndocrinology Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalSurgery Department, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, PortugalEndocrinology Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalGastroenterology Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalSurgery Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalOncology Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalEndocrinology Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalEndocrinology Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalGastroenterology Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalEndocrinology Department, Instituto Português de Oncologia de Coimbra Franscisco Gentil, EPE, Coimbra, PortugalGastric neuroendocrine neoplasms (GNENs) are classified into three types according to their aetiology. We present a clinical case of a female patient of 66 years and a well-differentiated (grade 2), type 3 GNEN with late liver metastasis (LM). The patient underwent surgical excision of a gastric lesion at 50 years of age, without any type of follow-up. Sixteen years later, she was found to have a neuroendocrine tumour (NET) metastatic to the liver. The histological review of the gastric lesion previously removed confirmed that it was a NET measuring 8 mm, pT1NxMx (Ki67 = 4%). 68Ga-DOTANOC PET/CT reported two LM and a possible pancreatic tumour/gastric adenopathy. Biopsies of the lesion were repeatedly inconclusive. She had a high chromogranin A, normal gastrin levels and negative anti-parietal cell and intrinsic factor antibodies, which is suggestive of type 3 GNEN. She underwent total gastrectomy and liver segmentectomies (segment IV and VII) with proven metastasis in two perigastric lymph nodes and both with hepatic lesions (Ki67 = 5%), yet no evidence of local recurrence. A 68Ga-DOTANOC PET/CT was performed 3 months after surgery, showing no tumour lesions and normalisation of CgA. Two years after surgery, the patient had no evidence of disease. This case illustrates a rare situation, being a type 3, well-differentiated (grade 2) GNEN, with late LM. Despite this, it was possible to perform surgery with curative intent, which is crucial in these cases, as systemic therapies have limited efficacy. We emphasise the need for extended follow-up in these patients.https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-18-0048 |
| spellingShingle | Bernardo Marques Raquel G Martins Guilherme Tralhão Joana Couto Sandra Saraiva Henrique Ferrão João Ribeiro Jacinta Santos Teresa Martins Ana Teresa Cadime Fernando Rodrigues Gastric neuroendocrine neoplasm with late liver metastasis Endocrinology, Diabetes & Metabolism Case Reports |
| title | Gastric neuroendocrine neoplasm with late liver metastasis |
| title_full | Gastric neuroendocrine neoplasm with late liver metastasis |
| title_fullStr | Gastric neuroendocrine neoplasm with late liver metastasis |
| title_full_unstemmed | Gastric neuroendocrine neoplasm with late liver metastasis |
| title_short | Gastric neuroendocrine neoplasm with late liver metastasis |
| title_sort | gastric neuroendocrine neoplasm with late liver metastasis |
| url | https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-18-0048 |
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