Malladi UD, Chimata SK, Bhashyakarla RK, Lingampally SR, Venkannagari VR, Mohammed ZA, Vargiya RV. Duodenal neuroendocrine tumor-tertiary care centre experience: A case report. World J Transl Med 2023; 11(1): 1-8 [DOI: 10.5528/wjtm.v11.i1.1]
Corresponding Author of This Article
Uma Devi Malladi, MD, Professor, Department of Medical Gastroenterology, Osmania General Hospital, No. 504 Liver care unit-First floor, Telangana, Hyderabad 500012, India. umadevimalladi_66@yahoo.co.in
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Uma Devi Malladi, Suraj Kumar Chimata, Ramesh Kumar Bhashyakarla, Sahitya Reddy Lingampally, Vikas Reddy Venkannagari, Zeeshan Ali Mohammed, Rahul Vijay Vargiya, Department of Medical Gastroenterology, Osmania General Hospital, Telangana, Hyderabad 500012, India
Author contributions: Malladi UD, Bhashyakarla RK, and Lingampally SR have contributed to case diagnosis, manuscript conceptualization, and supervision; Chimata SK has contributed to data collection and manuscript framing and editing; Venkannagari VR, Mohammed ZA, and Vargiya RV have contributed to data collection; All the authors have read and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient and her parents for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Uma Devi Malladi, MD, Professor, Department of Medical Gastroenterology, Osmania General Hospital, No. 504 Liver care unit-First floor, Telangana, Hyderabad 500012, India. umadevimalladi_66@yahoo.co.in
Received: April 23, 2023 Peer-review started: April 23, 2023 First decision: June 19, 2023 Revised: July 5, 2023 Accepted: August 17, 2023 Article in press: August 17, 2023 Published online: August 31, 2023
Abstract
BACKGROUND
Neuroendocrine neoplasms (NENs) are a heterogeneous group of neoplasms arising from neuroendocrine cells, which contribute a small fraction of gastrointestinal malignancies. Duodenal neuroendocrine tumors (dNETs) represent 2% of all gastroenteropancreatic NENs. NENs are heterogeneous in terms of clinical symptoms, location, and prognosis. Non-functional NETs are mostly asymptomatic and need a high degree of clinical suspicion. Diagnosis of NETs is by endoscopic, endosonographic biopsy, and histopathological examination with immunohistochemistry staining for synaptophysin and chromogranin A.
CASE SUMMARY
We present case reports of 5 patients obtained over a period of 10 years in our center with dNETs. One patient had moderately differentiated NET and the remaining four had well-differentiated NET. Surveillance endoscopy was recommended in all the patients and is kept under regular follow-up after performing endoscopic therapy using endoscopic mucosal resection in 4 of them and one patient was advised to undergo a Whipple procedure.
CONCLUSION
Recently, the number of reported cases of NETs has increased due to advancements in diagnostic modalities and prevalence because of longer survival duration. The management differs based on the site, size, proliferation grade, and locally invasive pattern. They are slow-growing tumors with a good overall prognosis. The prognosis correlates with local lymph node status and metastasis.
Core Tip: Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms arising from neuroendocrine cells. Non-functional NETs are mostly asymptomatic and need a high degree of clinical suspicion. Duodenal NETs represent nearly 2% of all Gastroenteropancreatic neoplasms, most of which are sporadic and non-functional. The average age of presentation is 60 years with a slight male preponderance. NETs are categorized by the World Health Organization classification, and radical surgery is the only curative therapy. Endoscopic therapy is especially validated for sub-centimetric lesions and surgical intervention is recommended for lesions above 2 cm, sporadic gastrinoma, periampullary location, and poorly differentiated d-NET.
