tailieunhanh - báo cáo khoa học: "Multivisceral resection of pancreatic neuroendocrine tumours: a report of two cases"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Multivisceral resection of pancreatic neuroendocrine tumours: a report of two cases | Gundara et al. World Journal of Surgical Oncology 2011 9 93 http content 9 1 93 5 2 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Multivisceral resection of pancreatic neuroendocrine tumours a report of two cases 1 11 12 Justin S Gundara Raul Alvarado-Bachmann Nicholas Williams Sivakumar Gananadha Anthony Gill Thomas J Hugh1 and Jaswinder S Samra1 Abstract Pancreatic neuroendocrine tumours pNETs are rare and surgical resection offers the only possibility of cure for localised disease. The role of surgery in the setting of locally advanced and metastatic disease is more controversial. Emerging data suggests that synchronous surgical resection of pancreas and liver may be associated with increased survival. We report two cases of synchronous one stage multivisceral resections for pNET and associated reconstruction. We highlight the technical issues involved in such extensive resections and demonstrate that one stage multivisceral operations can be achieved safely. Keywords pancreatoduodenectomy neuroendocrine pNET islet cell carcinoma GEP-NET Background Pancreatic neuroendocrine tumours pNETs are relatively rare with an annual incidence of two to three cases per million of population 1 . Such tumours can be classified as functional or non-functional. In earlier studies functional tumours were more common than non-functional tumours. However more recent data suggests that up to 85 of pNETs are non-functioning 1 2 . Patients with functional tumours usually present earlier due to unique clinical symptoms caused by hormone hypersecretion. In contrast non-functioning tumours present later with non-specific symptoms and patients often have metastatic disease at the time of diagnosis 3 . TNM staging the modified WHO classification and Ki-67 proliferative index may predict recurrence but are less useful in individual cases due to the unpredictable nature of this disease 4 . For a solitary pNET resection remains the best option for long term cure 3 .