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.
3 months ago
Journal
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SSTR (Somatostatin Receptor)
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SSTR positive
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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.
From August 2019 to October 2020, he received long-acting octreotide and transarterial chemoembolization (TACE), achieving stable disease...In September 2022, oral surufatinib was initiated but paused in September 2023 due to adverse effects...This case demonstrates that everolimus can induce SSTR re-expression in advanced, SSTR-negative pNETs, offering new therapeutic possibilities. The "induction plus re-evaluation" approach could guide personalized treatment strategies in late-stage pNETs, although further studies are needed to validate this approach.