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Endoscopic ultrasound ablation in a patient with multiple metastatic pancreatic tumors from adrenocorticotropic hormone-producing thymic neuroendocrine neoplasm.
Chang, Ling-Kai; Chen, Kuan-Chih; Cheng, Mei-Fang; Lin, Chia-Chi; Wang, Hsiu-Po; Sung, Chia-Tung; Chen, Jou-Ho; Yen, Ruoh-Fang; Hsu, Chia-Lin; Shih, Shyang-Rong.
Afiliação
  • Chang LK; Departments of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Chen KC; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
  • Cheng MF; Department of, Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Lin CC; Department of, Oncology, National Taiwan University Hospital, Taipei, Taiwan.
  • Wang HP; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
  • Sung CT; Departments of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Chen JH; Department of, Pathology, National Taiwan University Hospital, Taipei, Taiwan.
  • Yen RF; Institute of Forensic Medicine, Medical Center, National Taiwan University, Taipei, Taiwan.
  • Hsu CL; Departments of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Shih SR; Department of, Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Dig Endosc ; 33(3): 458-463, 2021 Mar.
Article em En | MEDLINE | ID: mdl-32462727
Adrenocorticotropic hormone (ACTH)-producing neuroendocrine neoplasm (NEN) of the thymus is rare. Lymph nodes and bones are the most common metastatic sites. Most cases present with florid Cushing's syndrome (CS). Here, we reported a 58-year-old woman, who presented with intermittent flush and weight loss. Imaging studies revealed tumors in the mediastinum, pancreas, and bones. Contrast-enhanced harmonic endoscopic ultrasound (EUS) of the pancreatic tumors showed heterogeneous and hyperenhancing characteristics. EUS elastography revealed a heterogeneous stiff pattern. EUS-fine needle biopsy to the pancreatic lesion confirmed the NEN nature. Serum ACTH and cortisol levels were abnormally high. Immunohistochemical staining of the thymic and pancreatic specimens was positive for ACTH. However, the patient did not have obvious CS appearance. The patient underwent surgery, radiation, EUS-guided ethanol injection, and anti-cancer medications, but the disease still progressed. The patient died from infection 16 months after NEN was diagnosed. In conclusion, the pancreas can be a metastatic site for ACTH-producing thymic NEN. EUS-associated procedures can help in the diagnosis and treatment of pancreatic metastatic NEN.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Tumores Neuroendócrinos Limite: Female / Humans / Middle aged Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Tumores Neuroendócrinos Limite: Female / Humans / Middle aged Idioma: En Ano de publicação: 2021 Tipo de documento: Article