Successful use of biotherapy with somatostatin analogues in the treatment of a patient with multiple endocrine neoplasia type 1

Abstract

The syndrome of multiple endocrine neoplasia type I, MEN-1, or Wermer’s syndrome, occupies a separate place in the group of neuroendocrine tumors. Being a genetic, family-determined disease and having a transmission rate of 50%, it is manifested by multiple neoplasms of various malignant potential in many organs. Given the trend towards personalization of treatment, specialists in various fields are constantly looking for improved diagnostics and new methods of treatment. We present our own experience in the treatment of MEN-1 syndrome with somatostatin analogues. The patient, born in 1972, was observed by an endocrinologist at the age of 22, when a pituitary microadenoma was detected. After 18 years, a pancreatic tumor was detected, which was successfully removed. Histological and immunohistochemical studies verified a Grade 1 neuroendocrine tumor. Control computed tomography revealed multiple masses in the head and tail of the pancreas. Given the condition, patients since 2013 have been prescribed biotherapy with an analogue of somatostatin – octreotide. However, taking the drug was not regular, and the patient noted a deterioration in her condition. In 2019, by decision of the council, biotherapy with Lanreotide was prescribed. Even taking into account irregular examinations due to absenteeism, the control examination in 2022 showed normalization of the levels of chromogranin A and serotonin, the absence of new tumor foci and the progression of those present during Positron emission tomography. Thus, a multidisciplinary approach and the appointment of adequate therapy helps to improve the quality of life and stabilize patients with MEN-1 syndrome.