| Autor: |
Regolo M; Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.; Academic Unit of Internal Medicine, Cannizzaro Hospital, 95126 Catania, Italy., Cardaci N; Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.; Academic Unit of Internal Medicine, Cannizzaro Hospital, 95126 Catania, Italy., Salmeri C; Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.; Academic Unit of Internal Medicine, Cannizzaro Hospital, 95126 Catania, Italy., Laudani A; Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.; Academic Unit of Internal Medicine, Cannizzaro Hospital, 95126 Catania, Italy., Colaci M; Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.; Academic Unit of Internal Medicine, Cannizzaro Hospital, 95126 Catania, Italy., Ippolito M; Nuclear Medicine Unit, Cannizzaro Hospital, 95126 Catania, Italy., Motta F; Pathological Anatomy Unit, Cannizzaro Hospital, 95126 Catania, Italy., Magrì S; Endoscopy Unit, Cannizzaro Hospital, 95126 Catania, Italy., Parisi S; Endoscopy Unit, Cannizzaro Hospital, 95126 Catania, Italy., Torcitto AG; Radiology Unit, Cannizzaro Hospital, 95126 Catania, Italy., Malatino L; Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.; Academic Unit of Internal Medicine, Cannizzaro Hospital, 95126 Catania, Italy. |
| Abstrakt: |
A pancreatic neuroendocrine tumor (Pan-NET) is a rare neoplasm originating in the neuroendocrine system. Carcinoid syndrome occurs in approximately 19% of patients with functional Pan-NETs, typically when liver metastases occur. In this paper, we describe the case of a patient with a low-grade non-functional Pan-NET, but with a typical clinical presentation of carcinoid syndrome. An 81-year-old male was admitted to our Department of Internal Medicine at Cannizzaro Hospital (Catania, Italy) because of the onset of abdominal pain with nausea, loose stools, and episodic flushing. Firstly, an abdominal contrast-enhanced CT scan showed a small pancreatic hyper-vascular mass; then, a gallium-68 DOTATOC integrated PET/CT revealed an elevated expression of SSTR receptors. Serum chromogranin A and urinary 5-HIAA measurements were negative. We performed an endoscopic ultrasonography (EUS) by a fine-needle biopsy (EUS-FNB), allowing the immunostaining of a small mass (0.8 cm) and the diagnosis of a low-grade (G1) non-functional Pan-NET (NF-Pan-NET). Surgery was waived, while a follow-up strategy was chosen. The early recognition of Pan-NETs, although rare, is necessary to improve the patient's survival. Although helpful to allow for immunostaining, EUS-FNB needs to be warranted in future studies comparing EUS-FNB to EUS-FNA (fine-needle aspiration), which is, to date, reported as the tool of choice to diagnose Pan-NETs. |
