title: Comprehensive treatment of a functional pancreatic neuroendocrine tumor with multifocal liver metastases.
abstract: A 64-year-old man was admitted to the Sun Yat-Sen University Cancer Center with chief complaints of recurrent abdominal pain and diarrhea for about 3 years and with a history of surgical repair for intestinal perforation owing to stress ulcer. Positron emission tomography (PET)/computed tomography (CT) demonstrated a primary tumor on the pancreatic tail with multifocal liver metastases. Pathological and immunohistochemistry staining revealed the lesion to be a pancreatic neuroendocrine tumor (pNET). According to the latest World Health Organization (WHO, 2013) classification, the tumor was classified as stage IV functional G1 pNET. After referral to the multidisciplinary treatment board (MDT), the patient was started on periodic dose of omeprazole, somatostatin analogues and Interferon α (IFNα) and had scanning follow-ups. Based upon the imaging results, CT-guided radioactive iodine-125 ((125)I) seeds implantation therapy, radiofrequency ablation therapy (RFA) or microwave ablation technique were chosen for the treatment of the primary tumor. Transarterial chemoembolization (TACE), RFA and microwave ablation techniques were decided upon for liver metastases. The patient showed beneficial response to the treatment with clinically manageable low-grade side effects and attained partial remission (RECIST criteria) with a good quality of life.
authors.affiliation: 1 Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China ; 2 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: 1 Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China ; 2 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
authors.forename: Sharvesh Raj
authors.initials: SR
authors.lastname: Seeruttun
authors.affiliation: 1 Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China ; 2 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Fang
authors.affiliation: 1 Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China ; 2 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Zhou
keywords: Pancreatic neuroendocrine tumor (pNET); functional; liver metastases; multidisciplinary team; prognosis