Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Non-functional pancreatic neuroendocrine tumor (P-NET) presented by abdominal pain: case report and literature review

Matteo Regolo
ORCID logo ,
Nicolas Cardaci
,
Clara Salmeri
,
Alfredo Laudani
,
Michele Colaci
ORCID logo ,
Massimo Ippolito
,
Fabio Motta
,
Salvatore Magrì
,
Stefanie Parisi
,
Alfredo Gaetano Torcitto
,
Lorenzo Malatino
* ORCID logo
Version 1 : Received: 14 August 2023 / Approved: 14 August 2023 / Online: 14 August 2023 (16:01:25 CEST)
Version 2 : Received: 14 September 2023 / Approved: 15 September 2023 / Online: 18 September 2023 (13:31:36 CEST)

How to cite: Regolo, M.; Cardaci, N.; Salmeri, C.; Laudani, A.; Colaci, M.; Ippolito, M.; Motta, F.; Magrì, S.; Parisi, S.; Torcitto, A.G.; Malatino, L. Non-functional pancreatic neuroendocrine tumor (P-NET) presented by abdominal pain: case report and literature review. Preprints 2023, 2023081058. https://doi.org/10.20944/preprints202308.1058.v1 Regolo, M.; Cardaci, N.; Salmeri, C.; Laudani, A.; Colaci, M.; Ippolito, M.; Motta, F.; Magrì, S.; Parisi, S.; Torcitto, A.G.; Malatino, L. Non-functional pancreatic neuroendocrine tumor (P-NET) presented by abdominal pain: case report and literature review. Preprints 2023, 2023081058. https://doi.org/10.20944/preprints202308.1058.v1

Abstract

Pancreatic neuroendocrine tumor (P-NET) is a rare neoplasm originating in the neuroendocrine system. Carcinoid syndrome occurs in approximately 19% of patients with functional P-NETs, typically when liver metastases occur. NETs diagnosis is frequently late, along with symptoms related to hormone hypersecretion. We described the case of a patient with a low-grade non-functional P-NET, but with a typical clinical presentation of a carcinoid syndrome; moreover, we reviewed the literature regarding this topic. An 81-year-old male was admitted to our Department of Internal Medicine at Cannizzaro Hospital (Catania, Italy) because of the onset of abdominal pain with nausea, loose stools and episodic flushing. Firstly, an abdominal contrast-enhanced CT scan showed a small pancreatic hypervascular mass; then a gallium-68 DOTATOC integrated PET/CT revealed an elevated expression of SSTR receptors. Serum Chromogranin A and urinary 5-HIAA measurements resulted negative. Given the small size of the lesion (8 mm), we preferred to perform an endoscopic ultrasonography (EUS) with fine-needle biopsy (EUS-FNB), allowing the diagnosis of low-grade (G1) non-functional P-NET (NF-P-NET). Surgery was waived, while a follow-up strategy was chosen. Early recognition of P-NETs, although rare, is necessary to improve patient’s survival. EUS-FNB should be the protocol of choice for an early characterization of these tumors.

Keywords

Neuroendocrine tumors; NETs; pancreatic neuroendocrine tumors; P-NETs; endoscopic ultrasonography; EUS-FNA; EUS-FNB

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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