Renal Metastasis from a Primary Hepatic Neuroendocrine Tumor: A Case Report and Literature Review

Year 2024, Volume: 77 Issue: 3, 293 - 297, 10.10.2024

Altay Alıyev , Arturan Ibrahimli , Tarana Hüseynli Natavan Azizova Gülnar Aghayeva Akbar Hajiyev Elgun Samadov

Abstract

Neuroendocrine tumors (NET) are a diverse collection of neoplasms with varying biological characteristics, histologic patterns, and therapeutic
responses. We present a rare case of a 41-year-old female who was diagnosed with a primary NET of the liver and had multiple kidney and bone
metastases. Primary hepatic NETs are rare, and metastasis to the kidney makes this case one of the few in the literature. The patient was admitted
to the hospital because of pain in the lower extremities. Several imaging examinations revealed multiple lesions in the bone, kidney, and liver.
Sandostatin and Denosumab treatments are started against the tumor and bone metastases. At first, the team thought the case was a NET of the
liver and synchronous renal cell carcinoma. However, after the total excision of the kidney, pathology was reported as the NET metastasis to the
kidney. Despite showing regression in bone metastases, the lesion in the the liver has advanced. 177Lu-DOTATATE treatment was added to the current
treatment regimen. Renal metastasis from a primary hepatic NET can be challenging to diagnose and treat. Since there are no guidelines specifically
designed for this type of case, multiple treatment modalities must be discussed with a multidisciplinary team to choose the best option for patients

Keywords

Neuroendocrine tumor , primary hepatic neuroendocrine tumor , renal metastasis , sandostatin

Ethical Statement

Informed consent was obtained from the patient.

Supporting Institution

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Project Number

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Thanks

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Primer Karaciğer Nöroendokrin Tümörünün Böbrek Metastazı: Nadir Olgu ve Literatür Taraması

Abstract

Nöroendokrin tümörler (NET), değişen biyolojik özelliklere, histolojik yapılara ve terapötik yanıtlara sahip çok çeşitli neoplazmalar koleksiyonudur.
Bu makalede karaciğerde primer NET tanısı alan, çok sayıda böbrek ve kemik metastazı bulunan 41 yaşında kadın hastayı sunuyoruz. Primer hepatik
NET’ler nadirdir ve böbreğe metastaz olması durumu daha da nadir hale getirir. Hasta alt ekstremite ağrısı nedeniyle hastaneye başvurdu. Çeşitli
görüntülemelerde kemik, böbrek ve karaciğerde çok sayıda lezyon ortaya çıktı. Tümör ve kemik metastazlarına karşı Sandostatin ve Denosumab
tedavilerine başlandı. Ekip ilk başta vakanın karaciğerde nöroendokrin bir tümör ve senkron renal hücreli karsinom olduğunu düşündü. Ancak
böbreğin total eksizyonu sonrasında patoloji, NET’in böbreğe metastazı olarak rapor edildi. Kemik metastazlarında gerileme görülmesine rağmen
karaciğerdeki primer lezyonu ilerledi. Mevcut tedavi rejimine 177Lu-DOTATATE tedavisi eklendi. Primer hepatik NET’ten kaynaklanan renal metastazın
teşhis ve tedavisi zor olabilir. Bu tip vakalar için özel olarak tasarlanmış bir kılavuz bulunmadığından, hastalar için en iyi seçeneğin seçilebilmesi için
birden fazla tedavi yönteminin multidisipliner bir ekiple tartışılması gerekir.

Keywords

Nöroendokrin tümör , primer karaciğer nöroendokrin tümörü , böbrek metastazı , sandost

Ethical Statement

Informed consent was obtained from the patient.

Supporting Institution

-

Project Number

-

Thanks

-

References

• 1. Xia Y, Zhang L, Wu H, et al. Primary hepatic neuroendocrine tumor with multiple liver metastases: A case report with literature review. J Int Med Res. 2020;48:300060520932114.
• 2. Tuan Linh L, Minh Duc N, Tu Minh H, et al. Primary hepatic neuroendocrine tumor. Endocrinol Diabetes Metab Case Rep. 2021;2021:20-0220.
• 3. Klimstra DS, Modlin IR, Coppola D, et al. The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas. 2010;39:707-712.
• 4. Nikfarjam M, Muralidharan V, Christophi C. Primary hepatic carcinoid tumours. HPB (Oxford). 2004;6:13-17.
• 5. Eriksson B, Oberg K, Stridsberg M. Tumor markers in neuroendocrine tumors. Digestion. 2000;62(Suppl 1):33-38.
• 6. Tal R, Lask DM, Livne PM. Metastatic renal carcinoid: case report and review of the literature. Urology. 2003;61:838.
• 7. Scurelli A, Bertoli G, Bedani A, et al. [Ileal carcinoid observed in a very advanced phase in presence of metastasis to the left thigh soft tissues, both kidneys, liver, and left lung]. Arch Sci Med (Torino). 1983;140:89-99.
• 8. Kato Y, Nakamura K, Yamada Y, et al. A rare case of metastatic renal carcinoid. BMC Urol. 2010;10:22.
• 9. Ali M, Irma L, Ganesan S. Isolated renal metastasis from neuroendocrine tumor: how rare is rare? A case report and review of the literature. J Urol Surg. 2016;1:25-27.
• 10. Romero FR, Rais-Bahrami S, Permpongkosol S, et al. Primary carcinoid tumors of the kidney. J Urol. 2006;176:2359-2366.
• 11. Schwartz G, Colanta A, Gaetz H, et al. Primary carcinoid tumors of the liver. orld J Surg Oncol. 2008;6:91.
• 12. O’Dorisio TM, Harris AG, O’Dorisio MS. Evolution of Neuroendocrine Tumor Therapy. Surg Oncol Clin N Am. 2020;29:145-163.
• 13. Stueven AK, Kayser A, Wetz C, et al. Somatostatin Analogues in the Treatment of Neuroendocrine Tumors: Past, Present and Future. Int J Mol Sci. 2019;20:3049.
• 14. Lee H, Eads JR, Pryma DA. 68 Ga-DOTATATE Positron Emission Tomography- Computed Tomography Quantification Predicts Response to Somatostatin Analog Therapy in Gastroenteropancreatic Neuroendocrine Tumors. Oncologist. 2021;26:21-29.
• 15. Lipton A, Fizazi K, Stopeck AT, et al. Superiority of denosumab to zoledronic acid for prevention of skeletal-related events: a combined analysis of pivotal, randomised, phase 3 trials. Eur J Cancer. 2012;48:3082-3092.
• 16. Das S, Al-Toubah T, El-Haddad G, et al. 177Lu-DOTATATE for the treatment of gastroenteropancreatic neuroendocrine tumors. Expert Rev Gastroenterol Hepatol. 2019;13:1023-1031.
• 17. Kushwaha NK, Jaiswal P, Gupta P, et al. Primary hepatic functional neuroendocrine tumor in an elderly female: Case report. Clin Case Rep. 2023;12:e8382.