A case of successful conversion from everolimus to surgical resection of a giant pancreatic neuroendocrine tumor

Abstract Background Although pancreatic neuroendocrine tumors generally have a far better prognosis relative to pancreatic cancer, the varied manifestations lead to treatment-related challenges. Everolimus therapy is generally recommended for patients with advanced pancreatic neuroendocrine tumors;...

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Main Authors: Asahi Sato, Toshihiko Masui, Nao Sankoda, Kenzo Nakano, Yuichiro Uchida, Takayuki Anazawa, Kyoichi Takaori, Yoshiya Kawaguchi, Shinji Uemoto
Format: Article
Language:English
Published: Japan Surgical Society 2017-07-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-017-0361-8
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author Asahi Sato
Toshihiko Masui
Nao Sankoda
Kenzo Nakano
Yuichiro Uchida
Takayuki Anazawa
Kyoichi Takaori
Yoshiya Kawaguchi
Shinji Uemoto
author_facet Asahi Sato
Toshihiko Masui
Nao Sankoda
Kenzo Nakano
Yuichiro Uchida
Takayuki Anazawa
Kyoichi Takaori
Yoshiya Kawaguchi
Shinji Uemoto
author_sort Asahi Sato
collection DOAJ
description Abstract Background Although pancreatic neuroendocrine tumors generally have a far better prognosis relative to pancreatic cancer, the varied manifestations lead to treatment-related challenges. Everolimus therapy is generally recommended for patients with advanced pancreatic neuroendocrine tumors; however, its efficacy in a neoadjuvant setting remains unclear. Here we present a case of a giant pancreatic neuroendocrine tumor with a portal tumor thrombus that became resectable after everolimus therapy. Case presentation A 62-year-old woman was admitted to our hospital for surgical resection of a giant pancreatic neuroendocrine tumor in the left upper abdomen. Unfortunately, she was ineligible for surgery because the tumor had extended near the hepatic hilus in the portal vein, and she was administered everolimus (10 mg/day). After 2 years of this therapy, the extent of portal vein involvement had decreased, despite the lack of significant changes in the tumor size, and the hepatic hilus became free of disease. She was subsequently referred to us for resection via distal pancreatectomy with portal vein reconstruction because the tumor had begun to grow slowly. Pathological review identified a grade 2 neuroendocrine tumor with no lymph node metastasis. The patient’s postoperative course was uneventful, and she has remained recurrence-free for 27 months, despite a lack of additional treatment. Conclusions Our experience suggests that everolimus could be useful for neoadjuvant therapy in cases of locally advanced pancreatic neuroendocrine tumor.
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spelling doaj-art-c5f4add6cfad4f55bc23940525dcdb8e2025-08-20T02:54:42ZengJapan Surgical SocietySurgical Case Reports2198-77932017-07-01311510.1186/s40792-017-0361-8A case of successful conversion from everolimus to surgical resection of a giant pancreatic neuroendocrine tumorAsahi Sato0Toshihiko Masui1Nao Sankoda2Kenzo Nakano3Yuichiro Uchida4Takayuki Anazawa5Kyoichi Takaori6Yoshiya Kawaguchi7Shinji Uemoto8Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto UniversityDivision of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto UniversityDivision of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto UniversityDivision of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto UniversityDivision of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto UniversityDivision of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto UniversityDivision of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto UniversityDivision of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto UniversityDivision of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto UniversityAbstract Background Although pancreatic neuroendocrine tumors generally have a far better prognosis relative to pancreatic cancer, the varied manifestations lead to treatment-related challenges. Everolimus therapy is generally recommended for patients with advanced pancreatic neuroendocrine tumors; however, its efficacy in a neoadjuvant setting remains unclear. Here we present a case of a giant pancreatic neuroendocrine tumor with a portal tumor thrombus that became resectable after everolimus therapy. Case presentation A 62-year-old woman was admitted to our hospital for surgical resection of a giant pancreatic neuroendocrine tumor in the left upper abdomen. Unfortunately, she was ineligible for surgery because the tumor had extended near the hepatic hilus in the portal vein, and she was administered everolimus (10 mg/day). After 2 years of this therapy, the extent of portal vein involvement had decreased, despite the lack of significant changes in the tumor size, and the hepatic hilus became free of disease. She was subsequently referred to us for resection via distal pancreatectomy with portal vein reconstruction because the tumor had begun to grow slowly. Pathological review identified a grade 2 neuroendocrine tumor with no lymph node metastasis. The patient’s postoperative course was uneventful, and she has remained recurrence-free for 27 months, despite a lack of additional treatment. Conclusions Our experience suggests that everolimus could be useful for neoadjuvant therapy in cases of locally advanced pancreatic neuroendocrine tumor.http://link.springer.com/article/10.1186/s40792-017-0361-8Neuroendocrine tumorEverolimusSunitinib malate68Ga-DOTATOC-PET/CT
spellingShingle Asahi Sato
Toshihiko Masui
Nao Sankoda
Kenzo Nakano
Yuichiro Uchida
Takayuki Anazawa
Kyoichi Takaori
Yoshiya Kawaguchi
Shinji Uemoto
A case of successful conversion from everolimus to surgical resection of a giant pancreatic neuroendocrine tumor
Surgical Case Reports
Neuroendocrine tumor
Everolimus
Sunitinib malate
68Ga-DOTATOC-PET/CT
title A case of successful conversion from everolimus to surgical resection of a giant pancreatic neuroendocrine tumor
title_full A case of successful conversion from everolimus to surgical resection of a giant pancreatic neuroendocrine tumor
title_fullStr A case of successful conversion from everolimus to surgical resection of a giant pancreatic neuroendocrine tumor
title_full_unstemmed A case of successful conversion from everolimus to surgical resection of a giant pancreatic neuroendocrine tumor
title_short A case of successful conversion from everolimus to surgical resection of a giant pancreatic neuroendocrine tumor
title_sort case of successful conversion from everolimus to surgical resection of a giant pancreatic neuroendocrine tumor
topic Neuroendocrine tumor
Everolimus
Sunitinib malate
68Ga-DOTATOC-PET/CT
url http://link.springer.com/article/10.1186/s40792-017-0361-8
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