Ocampo-Murguia A, Cruz-Zárate A, Ramírez-López JA, González-Muñoz LD

Language: Spanish
References: 6
Page: 50-53
PDF size: 672.88 Kb.

ABSTRACT

Introduction: neuroendocrine tumors are rare and heterogeneous neoplasms arising from enterochromaffin cells and are the leading cause of malignancy in the small intestine. They are often diagnosed at advanced stages, with metastasis present in 30% of cases at diagnosis. Clinical case: a 70-year-old female with a history of type II diabetes mellitus and hypertension presents with recurrent gastrointestinal bleeding. Initial endoscopic studies failed to determine the source of the bleeding, leading to abdominal angiography, which revealed an intestinal tumor and surrounding mesenteric fi brosis. A laparoscopic intestinal resection was performed, yielding a histopathological result of grade 2 neuroendocrine tumor. Conclusions: surgical management is the most critical aspect of treatment, aiming for complete resection (R0). During the procedure, sequential bimanual palpation of the small intestine from the Treitz angle to the ileocecal valve is essential to rule out lesions in other sites.

REFERENCES

1. Peng Y, Xu B, Zhang F, Wu R, Tong S, Mao Z. Incidence,survival, and prognostic nomogram of patients with smallintestinal neuroendocrine tumors: A SEER populationbasedstudy. Medicine (Baltimore). 2024; 103: e39616. doi:10.1097/MD.0000000000039616.

2. Tran CG, Sherman SK, Howe JR. The landmark series:management of small bowel neuroendocrine tumors. AnnSurg Oncol. 2021; 28: 2741-2751. doi: 10.1245/s10434-020-09566-4.

3. Soreide K, Stattner S, Hallet J. Surgery as a principle andtechnical consideration for primary tumor resection of smallbowel neuroendocrine tumors. Ann Surg Oncol. 2024; 31:1125-1137 doi: 10.1245/s10434-023-14610-0.

4. Clift AK, Kidd M, Bodei L, Toumpanakis C, Baum RP, ObergK et al. Neuroendocrine neoplasms of the small bowel andpancreas. Neuroendocrinology. 2020; 110: 444-476. doi:10.1159/000503721.

5. ASGE Standards of Practice Committee; Gurudu SR,Bruining DH, Acosta RD, Eloubeidi MA, Faulx AL et al. Therole of endoscopy in the management of suspected smallbowelbleeding. Gastrointest Endosc. 2017; 85: 22-31. doi:10.1016/j.gie.2016.06.013.

6. Mosquera-Klinger GA, Hernández AJ. Tumorneuroendocrino primario de intestino delgado, consangrado digestivo oscuro manifiesto: un reporte de caso.Rev Colomb Gastroenterol. 2018; 33: 318-323. doi:10.22516/25007440.16.