Table of Contents    
Case Report
 
Ileal neuroendocrine tumor metastasis to pancreas and liver: A case report
Michael Sean Bleszynski1, David F. Schaeffer2, Maja Segedi1,
1Department of General Surgery, University of British Columbia, Vancouver, Canada;
2Department of Pathology, University of British Columbia, Vancouver, Canada.

Article ID: 100066IJHPDMB2017
doi:10.5348/ijhpd-2017-66-CR-2

Address correspondence to:
Michael Bleszynski
MD, The University of British Columbia Faculty of Medicine, Department of Surgery,
Division of General Surgery, Vancouver General Hospital Rm 3100 – Jim Pattison Pavillion North,
950 West 10th Avenue, Vancouver, BC, V5Z 1M9 Canada
Canada

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How to cite this article:
Bleszynski MS, Schaeffer DF, Segedi M. Ileal neuroendocrine tumor metastasis to pancreas and liver: A case report. Int J Hepatobiliary Pancreat Dis 2017;7:11–14


Abstract

Introduction: Neuroendocrine tumors (NETs) formally known as carcinoids tumors are neoplasms that arise from enterochromaffin cells. The NETs most commonly occur in the gastro-intestinal tract and predominately within the ileum. Symptomatic ileal NETs have most likely metastasized to the liver at the time of diagnosis. Pancreatic metastasis from ileal NETs are exceptionally rare.
Case Report: A 76-year-old female with a primary ileal carcinoid underwent right hemi-colectomy secondary to bowel obstruction. One-year post bowel resection, the patient presented with carcinoid syndrome, imaging revealed a singular hepatic metastasis (segment 2) and a pancreatic tail mass. After radiologic workup with an abdominal CT, PET and octreotide scan a presumed diagnosis of recurrent metastatic NET was made. Multi-disciplinary rounds discussed the case. Laparoscopic distal pancreatectomy, splenectomy and radiofrequency ablation of the liver tumor were performed. Surgical pathology of the pancreatic mass was consistent with primary ileal carcinoid tumor.
Conclusion: Ileal NET metastasis to the pancreas is a rare phenomenon. Metastatic NET management should be discussed with a multi-disciplinary team. R0 resection of primary and metastatic NETs offers the only chance of cure. Loco-regional, systemic therapies, and surgical debulking can offer a survival benefit in un-resectable disease or in cases where resection incurs a high perioperative risk.

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Author Contributions:
Michael Sean Bleszynski – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
David F. Schaeffer – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Maja Segedi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published.
Guarantor of submission:
The corresponding author is the guarantor of submission
Conflict of interest:
Authors declare no conflict of interest.
Copyright:
© 2017 Michael Sean Bleszynski et. al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.