Volume 87 - 2024 - Fasc.4 - Case series
Successful reversal of intestinal obstruction by PRRT: two case reports and literature review of PRRT in Small Intestinal Neuroendocrine Tumors with mesenteric fibrosis
Small intestinal neuroendocrine tumors (SI-NETs) typically
follow an indolent disease course and are often accompanied by
mesenteric lymph node metastases upon diagnosis. These tumors
can incite a fibroblastic reaction within the mesenteric root. Here,
we present two cases of patients with symptomatic small bowel
obstruction due to such mesenteric involvement. These patients
underwent peptide receptor radionuclide therapy (PRRT),
resulting in the stabilization of the mesenteric mass and remarkable
improvements in obstructive symptoms. They experienced a return
to oral intake and were able to discontinue parenteral nutrition.
Despite some controversies, PRRT emerges as a promising
tool in managing the mesenteric mass and achieving a reversal
of debilitating complications such as obstruction and mesenteric
ischemia.
Long-term complete remission of two patients with synchronous liver metastasis from pancreatic cancer and underlying BRCA-2 mutation
Background: Pancreatic ductal adenocarcinoma (PDAC) has
a known poor prognosis. For a select group, those with BRCA
mutations, frontline platinum-based therapy and poly (ADPribose)
polymerase inhibitors are options that can potentially lead
to survival benefit.
Patients and methods: we present 2 cases of patients with BRCAmutated
pancreatic cancer with liver metastases that achieved a
remarkable long-term complete remission on platinum-based
chemotherapy.
Conclusion: Germline testing for BRCA is important in PDAC
because it influences treatment choices that impact survival.
Complete responses with chemotherapy alone are rarely observed
in metastatic PDAC, but may be seen upon treatment with
platinum-based therapy.
