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Pancreatic neuroendocrine tumor with metastasis to the spleen: a case report

BACKGROUND: Long-term term survival in patients with pancreatic neuroendocrine tumors has been reported, even in patients with metastatic disease. Metastases to the spleen are extremely rare, but have been reported from a number of primary malignancies, such as breast cancer, lung cancer, melanoma a...

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Autores principales: Sakuma, Yasunaru, Yasuda, Yoshikazu, Sata, Naohiro, Hosoya, Yoshinori, Shimizu, Atsushi, Fujii, Hirofumi, Matsubara, Daisuke, Fukushima, Noriyuki, Miki, Atsushi, Maeno, Misato, Lefor, Alan Kawarai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223534/
https://www.ncbi.nlm.nih.gov/pubmed/28068959
http://dx.doi.org/10.1186/s12885-016-3020-8
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author Sakuma, Yasunaru
Yasuda, Yoshikazu
Sata, Naohiro
Hosoya, Yoshinori
Shimizu, Atsushi
Fujii, Hirofumi
Matsubara, Daisuke
Fukushima, Noriyuki
Miki, Atsushi
Maeno, Misato
Lefor, Alan Kawarai
author_facet Sakuma, Yasunaru
Yasuda, Yoshikazu
Sata, Naohiro
Hosoya, Yoshinori
Shimizu, Atsushi
Fujii, Hirofumi
Matsubara, Daisuke
Fukushima, Noriyuki
Miki, Atsushi
Maeno, Misato
Lefor, Alan Kawarai
author_sort Sakuma, Yasunaru
collection PubMed
description BACKGROUND: Long-term term survival in patients with pancreatic neuroendocrine tumors has been reported, even in patients with metastatic disease. Metastases to the spleen are extremely rare, but have been reported from a number of primary malignancies, such as breast cancer, lung cancer, melanoma and ovarian cancer. This is the first report of a splenic metastasis from a primary pancreatic neuroendocrine tumor. CASE PRESENTATION: The patient presented as a 53 years old white male with anemia and fatigue. Physical examination revealed a left upper quadrant fullness and computed tomography showed a 24 cm left upper quadrant mass with multiple liver metastases, splenomegaly and a 1 cm mass in the spleen. Resection of the primary pancreatic tumor (T4N0M1) was accompanied by gastrectomy, splenectomy and resection of adherent bowel. The spleen contained a metastatic lesion 1.0 cm in diameter, consistent with a primary neuroendocrine tumor of the pancreas. This operation was followed 8 months later, by delayed resection of liver metastases. The patient receives monthly administration of somatostatin long-acting analogue and has undergone several ablations of liver lesions with percutaneous radiofrequency ablation as well as a second liver resection. The patient is alive seven years after initial presentation, with no evidence of disease on imaging studies. CONCLUSIONS: This is the first report of a splenic metastasis from a primary pancreatic neuroendocrine tumor. The patient initially presented with synchronous multiple liver metastases and a single splenic metastasis. After resection of the primary tumor and spleen, the patient has undergone aggressive cytoreductive surgery/ablation of liver lesions and somatostatin therapy with resulting long-term survival.
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spelling pubmed-52235342017-01-11 Pancreatic neuroendocrine tumor with metastasis to the spleen: a case report Sakuma, Yasunaru Yasuda, Yoshikazu Sata, Naohiro Hosoya, Yoshinori Shimizu, Atsushi Fujii, Hirofumi Matsubara, Daisuke Fukushima, Noriyuki Miki, Atsushi Maeno, Misato Lefor, Alan Kawarai BMC Cancer Case Report BACKGROUND: Long-term term survival in patients with pancreatic neuroendocrine tumors has been reported, even in patients with metastatic disease. Metastases to the spleen are extremely rare, but have been reported from a number of primary malignancies, such as breast cancer, lung cancer, melanoma and ovarian cancer. This is the first report of a splenic metastasis from a primary pancreatic neuroendocrine tumor. CASE PRESENTATION: The patient presented as a 53 years old white male with anemia and fatigue. Physical examination revealed a left upper quadrant fullness and computed tomography showed a 24 cm left upper quadrant mass with multiple liver metastases, splenomegaly and a 1 cm mass in the spleen. Resection of the primary pancreatic tumor (T4N0M1) was accompanied by gastrectomy, splenectomy and resection of adherent bowel. The spleen contained a metastatic lesion 1.0 cm in diameter, consistent with a primary neuroendocrine tumor of the pancreas. This operation was followed 8 months later, by delayed resection of liver metastases. The patient receives monthly administration of somatostatin long-acting analogue and has undergone several ablations of liver lesions with percutaneous radiofrequency ablation as well as a second liver resection. The patient is alive seven years after initial presentation, with no evidence of disease on imaging studies. CONCLUSIONS: This is the first report of a splenic metastasis from a primary pancreatic neuroendocrine tumor. The patient initially presented with synchronous multiple liver metastases and a single splenic metastasis. After resection of the primary tumor and spleen, the patient has undergone aggressive cytoreductive surgery/ablation of liver lesions and somatostatin therapy with resulting long-term survival. BioMed Central 2017-01-09 /pmc/articles/PMC5223534/ /pubmed/28068959 http://dx.doi.org/10.1186/s12885-016-3020-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Sakuma, Yasunaru
Yasuda, Yoshikazu
Sata, Naohiro
Hosoya, Yoshinori
Shimizu, Atsushi
Fujii, Hirofumi
Matsubara, Daisuke
Fukushima, Noriyuki
Miki, Atsushi
Maeno, Misato
Lefor, Alan Kawarai
Pancreatic neuroendocrine tumor with metastasis to the spleen: a case report
title Pancreatic neuroendocrine tumor with metastasis to the spleen: a case report
title_full Pancreatic neuroendocrine tumor with metastasis to the spleen: a case report
title_fullStr Pancreatic neuroendocrine tumor with metastasis to the spleen: a case report
title_full_unstemmed Pancreatic neuroendocrine tumor with metastasis to the spleen: a case report
title_short Pancreatic neuroendocrine tumor with metastasis to the spleen: a case report
title_sort pancreatic neuroendocrine tumor with metastasis to the spleen: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223534/
https://www.ncbi.nlm.nih.gov/pubmed/28068959
http://dx.doi.org/10.1186/s12885-016-3020-8
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