Abstract
Neuroendocrine tumors (NETs) are often misdiagnosed because they can involve any part of the body and have non-specific symptoms. Here, we report a case of a 39-year-old man with rectal neuroendocrine tumor (RNET) and hepatic metastases treated with a combination of radical surgery and Everolimus therapy. The patient complained of abdominal distension, pain, and constipation of one month duration. Enhanced CT scan of the abdomen, colonoscopy and Biopsy findings confirmed the diagnosis of rectal neuroendocrine tumor. As the anatomical structures were clear and the masses seemed to be resectable, we decided to initiate treatment with radical operation and Everolimus therapy. The patient has responded well to the treatment with no evidence of recurrence after 4 years of follow-up. This case is interesting because of the rarity of this neoplasm and its initial misdiagnosis as a giant hepatic carcinoma (hepatoma). It also demonstrates that a combination of curative surgical resection and Everolimus is a good option in a patient with large colorectal neuroendocrine tumors and massive hepatic metastases.
Highlights
Neuroendocrine tumors (NETs) originate from neuroendocrine cells, which are present throughout the body
We report a case of a 39-year-old man with rectal neuroendocrine tumor (RNET) and hepatic metastases treated with a combination of radical surgery and Everolimus therapy
Enhanced computed tomography (CT) scan of the abdomen, colonoscopy and Biopsy findings confirmed the diagnosis of rectal neuroendocrine tumor
Summary
Neuroendocrine tumors (NETs) originate from neuroendocrine cells, which are present throughout the body. When a NET is found in the liver, it is imperative that tests for extrahepatic tumors be undertaken [2]. The incidence of hepatic NETs has increased 5-fold over the past 30 years [3]. The precise etiology of NETs is not clear. These tumors are sporadic and show no sex-related differences [4]. Because the clinical manifestations of NETs are non-specific, it is difficult to obtain an early diagnosis [5], and misdiagnoses are not uncommon. As NETs can produce a variety of hormones, they may cause symptoms related to hormone secretion. An insulin-producing NET would cause hypoglycemia and is often misdiagnosed as a nervous system disease. We report a case of RNET with hepatic metastasis in a 39-year-old man, who was successfully treated with radical resection and Everolimus therapy as an adjuvant therapy
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