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第56回・2018年・横浜
 

腹腔鏡下腫瘍生検で診断した原発不明神経内分泌腫瘍多発肝転移の一例

演題番号 : P110-1

[筆頭演者]
演者)桐井 靖:1 
[共同演者]
依田 恭介:1、三澤 俊一:1、黒河内 顕:1、高木 洋行:1、太田 浩良:2

1:松本市立病院・外科、2:信州大学・保健学科・生体情報検査学

 

A 79 years old woman came to our hospital with a complaint of diarrhea from enterocolitis. Screening CT scanning with enhance study showed multiple liver tumors without any primary tumor lesion by endoscopic investigations. Tumor markers containing NSE, ProGRP, and other gastrointestinal hormones were within normal level. We decided to carry out a laparoscopic biopsy to liver tumors under general anesthesia with a temporary cardiac pacing because of her bradyarrhythmia. Pathological finding was equivalent to Gr2 neuroendocrine tumor according to WHO classification 2017. Somatostatin receptor scintigraphy showed marked accumulation to liver tumors without uptake to other organs. So we diagnosed her tumors as multiple liver metastases from unknown primary neuroendocrine tumor. Everolimus was prescribed but could not be continued because of thrombocytopenia, and somatostatin analog was started after permanent cardiac pace maker had been implanted. Liver metastases of unknown primary neuroendocrine tumor is not so rare, but sometimes difficult to diagnose. To make a definite pathological diagnosis laparoscopic tumor biopsy is very useful and safer. Somatostatin receptor scintigraphy is a powerful method to determine primary tumor site of neuroendocrine tumor. We suppose these methods to diagnose such tumors suspected as neuroendocrine tumor.

キーワード

臓器別:NET(神経内分泌腫瘍)

手法別:診断

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