Preoperative management included long-acting octreotide, niacin, and guideline-directed heart failure therapy, followed by tumor resection...Primary ovarian neuroendocrine neoplasms can cause carcinoid syndrome and right-sided valvulopathy without liver metastasis, likely because ovarian venous drainage bypasses hepatic first-pass metabolism. Multidisciplinary care enables prompt diagnosis, preoperative stabilization, definitive resection, and coordinated surveillance.
The patient was treated with capecitabine and temozolomide (CAPTEM) chemotherapy, pembrolizumab, long-acting repeatable octreotide (octreotide LAR), and diazoxide for hypoglycemia management. This case highlights the expanding phenotypic spectrum of Lynch syndrome and suggests that P-NETs may represent a rare but clinically significant manifestation. Early recognition of this association supports comprehensive genetic testing, enables the use of precision immunotherapy, and underscores the need for expanded surveillance strategies in patients with atypical tumor profiles.
The patient underwent cytoreductive debulking surgery, achieving approximately 70% tumor reduction, followed by long-acting octreotide therapy...This case report underscores the importance of early recognition and a multidisciplinary approach in managing indolent neuroendocrine tumors with multisite metastases. Combined surgical and medical strategies, including debulking surgery and octreotide therapy, can achieve durable disease control and favorable outcomes.
PRRT combined with everolimus-based immunosuppression has demonstrated controllable safety and preliminary antitumor activity in patients with relapsed NETLM after LT who have been strictly screened, but myelosuppression requires close monitoring and timely symptomatic treatment.
4 months ago
Journal
|
SSTR (Somatostatin Receptor)
|
SSTR positive
|
everolimus • Lutathera (lutetium Lu 177 dotatate) • octreotide acetate
Initial long-acting octreotide treatment was ineffective in controlling hyperthyroidism and was discontinued after 5 months. Despite SSTR2/5 positivity, suboptimal response to octreotide suggests tumor heterogeneity or downstream signaling defects. Preoperative Lugol's solution should be considered when SSAs and methimazole fail.
The patient underwent aortic valve replacement followed by long-acting octreotide therapy...This case represents an exceptionally rare scenario of pancreatic neuroendocrine tumor in a patient with prior lung carcinoid tumor and raises the critical question of pancreatic metastasis versus a second primary NET in the absence of hereditary syndromes. It underscores the need for heightened vigilance for second primary malignancies (SPMs) and atypical metastatic patterns in patients with a history of NETs and highlights the importance of multidisciplinary evaluation for accurate classification and optimal management.