Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Carcinoid is the most common neuroendocrine tumor. It is primarily localized in the ileum and the appendix, whereas other localizations are rare. Only a small number of the carcinoids present with carcinoid syndrome (flushing, diarrhea), usually after tumor has already metastasized. A case of carcinoid tumor of uncommon localization is reported. A 54-year-old male patient presented for evaluation because of weight loss, flushing and diarrhea. Laboratory value of 5-HIAA was 775.5 mmol/l (normal values up to 72.8) and the pancreatic tumor marker CA 19-9 was increased. Ultrasonographic and magnetic resonance find-Rings localized the tumor in the prepapillary pancreatic region and visualized the spread to the liver. The diagnosis was confirmed by pathohistologic evaluation of a liver biopsy specimen. The patient was treated with Sandostatin (octreotide analog), which led to significant relief of the symptoms, although control 5-HIAA values were not reduced.Iako su karcinoidi rijetki, predstavljaju najčešći tip neuroendokrinih tumora, primarno smještenih u tankom crijevu i apendiksu. Mali broj ovih tumora, nakon što metastazira u jetru, prezentira se simptomima karcinoidnog sindroma (rumenjača, proljevi). Prikazan je karcinoid gušterače, neuobičajene lokalizacije za ovu vrst tumora. Bolesnik u dobi od 54 godine upuaen je u kliniku zbog gubitka na težini, rumenjače i proljeva. Vrijednosti 5-HIAA i CA 19-9 bile su izrazito povišene. Ultrazvučno i magnetskom rezonancom prikazan je tumor predpapilarnog područja te uvećana jetra prožeta višestrukim sekundarizmima, a patohistološki nalaz govorio je u prilog neuroendokrinog tumora tipa karcinoida. S obzirom na proširenost procesa odustalo se od kirurškog liječenja te je započeta terapija Sandostatinom uza značajno kliničko poboljšanje, no bez učinka na 5-HIAA
