Life-threatening diarrhea in neuroendocrine tumors: two case reports
Abstract Background Neuroendocrine tumors are rare, heterogeneous neoplasms that produce a wide variety of clinical symptoms. Diarrhea in neuroendocrine tumors is incredibly common and is usually benign in nature. We report two extreme cases of diarrhea in metastatic neuroendocrine tumors that threa...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13256-021-03096-7 |
| _version_ | 1819044909296910336 |
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| author | Emma Gordon David L. Chan Jennifer Arena Elizabeth Bernard Emily Carr-Boyd Stephen J. Clarke Malinda Itchins Diana Learoyd Neomal Sandanayake Nick Pavlakis |
| author_facet | Emma Gordon David L. Chan Jennifer Arena Elizabeth Bernard Emily Carr-Boyd Stephen J. Clarke Malinda Itchins Diana Learoyd Neomal Sandanayake Nick Pavlakis |
| author_sort | Emma Gordon |
| collection | DOAJ |
| description | Abstract Background Neuroendocrine tumors are rare, heterogeneous neoplasms that produce a wide variety of clinical symptoms. Diarrhea in neuroendocrine tumors is incredibly common and is usually benign in nature. We report two extreme cases of diarrhea in metastatic neuroendocrine tumors that threatened fatality and provide evidence for steroids as a novel agent in the management of vasoactive intestinal peptide tumors. Case presentation A 63-year-old Caucasian male with a grade 2 (Ki-67 17%) metastatic small bowel neuroendocrine tumor, and a 43-year-old female with a grade 2 (Ki-67 5%) metastatic pancreatic vasoactive intestinal peptide tumor. Both patients suffered life-threatening diarrhea despite extensive treatment modalities, including new systemic agents. This case explains how a lack of compliance and patient under-reporting of symptoms contributed to their challenging clinical course. Only steroids had a significant sustained effect on the diarrhea of the patient with vasoactive intestinal peptide tumor. Conclusions This report discusses two rare cases of life-threatening diarrhea in neuroendocrine tumors and stresses the importance of accurate clinical history taking, patient education, and compliance for symptom control. The report suggests steroids as a potential novel pharmaceutical option in the management of vasoactive intestinal peptide tumors; this is of great significance as it may provide a new approach to their management and potentially act as a life-saving agent in other oncology patients. |
| first_indexed | 2024-12-21T10:20:10Z |
| format | Article |
| id | doaj.art-3cf2dfec90194f4cbaf1a4b73d751d2a |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-21T10:20:10Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-3cf2dfec90194f4cbaf1a4b73d751d2a2022-12-21T19:07:28ZengBMCJournal of Medical Case Reports1752-19472021-10-011511610.1186/s13256-021-03096-7Life-threatening diarrhea in neuroendocrine tumors: two case reportsEmma Gordon0David L. Chan1Jennifer Arena2Elizabeth Bernard3Emily Carr-Boyd4Stephen J. Clarke5Malinda Itchins6Diana Learoyd7Neomal Sandanayake8Nick Pavlakis9Royal College of General PractitionersDepartment of Medical Oncology, Royal North Shore HospitalDepartment of Medical Oncology, Royal North Shore HospitalDepartment of Nuclear Medicine, Royal North Shore Hospital (Sydney University)Department of Pathology, Royal North Shore HospitalDepartment of Medical Oncology, Royal North Shore HospitalDepartment of Medical Oncology, Royal North Shore HospitalGenesis Care North Shore, North Shore Health HubDepartment of Gastroenterology, Royal North Shore HospitalDepartment of Medical Oncology, Royal North Shore HospitalAbstract Background Neuroendocrine tumors are rare, heterogeneous neoplasms that produce a wide variety of clinical symptoms. Diarrhea in neuroendocrine tumors is incredibly common and is usually benign in nature. We report two extreme cases of diarrhea in metastatic neuroendocrine tumors that threatened fatality and provide evidence for steroids as a novel agent in the management of vasoactive intestinal peptide tumors. Case presentation A 63-year-old Caucasian male with a grade 2 (Ki-67 17%) metastatic small bowel neuroendocrine tumor, and a 43-year-old female with a grade 2 (Ki-67 5%) metastatic pancreatic vasoactive intestinal peptide tumor. Both patients suffered life-threatening diarrhea despite extensive treatment modalities, including new systemic agents. This case explains how a lack of compliance and patient under-reporting of symptoms contributed to their challenging clinical course. Only steroids had a significant sustained effect on the diarrhea of the patient with vasoactive intestinal peptide tumor. Conclusions This report discusses two rare cases of life-threatening diarrhea in neuroendocrine tumors and stresses the importance of accurate clinical history taking, patient education, and compliance for symptom control. The report suggests steroids as a potential novel pharmaceutical option in the management of vasoactive intestinal peptide tumors; this is of great significance as it may provide a new approach to their management and potentially act as a life-saving agent in other oncology patients.https://doi.org/10.1186/s13256-021-03096-7Neuroendocrine tumorDiarrheaVIPomaCase report |
| spellingShingle | Emma Gordon David L. Chan Jennifer Arena Elizabeth Bernard Emily Carr-Boyd Stephen J. Clarke Malinda Itchins Diana Learoyd Neomal Sandanayake Nick Pavlakis Life-threatening diarrhea in neuroendocrine tumors: two case reports Journal of Medical Case Reports Neuroendocrine tumor Diarrhea VIPoma Case report |
| title | Life-threatening diarrhea in neuroendocrine tumors: two case reports |
| title_full | Life-threatening diarrhea in neuroendocrine tumors: two case reports |
| title_fullStr | Life-threatening diarrhea in neuroendocrine tumors: two case reports |
| title_full_unstemmed | Life-threatening diarrhea in neuroendocrine tumors: two case reports |
| title_short | Life-threatening diarrhea in neuroendocrine tumors: two case reports |
| title_sort | life threatening diarrhea in neuroendocrine tumors two case reports |
| topic | Neuroendocrine tumor Diarrhea VIPoma Case report |
| url | https://doi.org/10.1186/s13256-021-03096-7 |
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