Endocrine Abstracts

Introduction: Peptide receptor radionuclide therapy is indicated in case of patients with disseminated neuroendocrine tumors and is usually considered as palliative treatment.

Case reports: 55 years old man diagnosed with tumor of the pancreatic head. On laparotomy performed in June 2012 tumor was stated unresectable. Histopathological examination revealed the mixed adeno-neuroendocrine cancer (MANEC). Patient was qualified to chemotherapy with gemcitabine. However progression of the tumor size was visible after 4 months of therapy. Due to ineffectiveness of chemotherapy and positive result of somatostatin receptor scintigraphy, with increased uptake of the tracer in the solid part of the tumor, patient was qualified to peptide receptor radionuclide therapy. Imaging examinations (ultrasound examination, computed tomography, somatostatin receptor scintigraphy) performed after PRRT confirmed decrease of the tumor size (both solid and cystic part of the tumor) from 90 mm prior to the therapy to 43 mm after treatment. Patient was referred to surgical department.

61 years old woman with tumor of the pancreatic head. On laparotomy performed in February 2013 tumor was stated unresectable. Histopathological examination revealed neuroendocrine tumor of the pancreas with Ki67 5 – 10% (NETG2). Somatostatin receptor scintigraphy revealed increased uptake of the tracer in the tumor. Patient was qualified to peptide receptor radionuclide therapy. Treatment led to decrease of the tumor size from 80 mm prior to PRRT to 44 mm after the therapy. Patient was referred to surgical department.

Conclusions: Above case reports indicates that peptide receptor radionuclide therapy might be also considered as form of neoadjuvant treatment. Moreover the case of patient with mixed adeno-neuroendocrine cancer shows that peptide receptor radionuclide therapy might be also considered in case of ineffectiveness of chemotherapy.