CLINICAL CASE: NEUROENDOCRINE TUMOR OF THE SMALL INTESTINE - METASTASES IN THE LIVER, PANCREAS AND KINDEY. THE RARITY OF OBSERVATION

Abstract

Neuroendocrine neoplasms are produced by a unique group of epithelial neoplasias that exhibit common neuroendocrine characteristics and have specific terminology, classification, semiotics, and specific approaches to diagnosis and treatment. Neuroendocrine neoplasms (NEP) are most often found in the gastrointestinal tract (GIT), mainly in the small intestine. The most frequently detected metastases of GIT NEP are metastases in the liver (95%), distant metastases to other organs, such as the pancreas or kidney are extremely rare. Case report: a 45-year-old patient K., who was admitted to the department of tumors of the liver and pancreas of N.N. Blokhin National Medical Research Center of Oncology with the diagnosis of primary-multiple synchronous neoplasms: 1) neuroendocrine tumor of the small intestine G2-Ki 67 = 12% with synchronous bilobar metastases in the liver, under an operation in 2010; 2) left kidney cancer, under an operation in 2011. During the dynamic observation in 2017, lesions in the pancreas, kidney and liver were identified. After the necessary examination, a preliminary diagnosis was made as small intestine neuroendocrine tumors with liver, pancreas and kidney metastases. The patient underwent surgical treatment in the volume of resection of the hook-shaped process of the pancreas with the tumor, distal pancreas resection, splenectomy, liver resection and resection of the right kidney. According to the morphological study, changes in the pancreas, kidney, and liver corresponded with the metastases of the small intestine neuroendocrine tumor. Conclusion: Patients with pancreas and kidney metastases of small intestine neuroendocrine tumors are extremely rare to observe. Surgical therapy can be considered the only radical treatment for this case.