Case Report


An Unusual Neuroendocrine Tumor

Authors: Armeen Lakhani, Naila Zahid, Mirza Arshad Beg
DOI: https://doi.org/10.37184/lntbj.2708-7808.2.12
Year: 2020
Volume: 2
Received: Oct 02, 2020
Revised: Feb 03, 2021
Accepted: Feb 15, 2021
Corresponding Auhtor: Armeen Lakhani



INTRODUCTION

A unique group of malignant growths – NEUROENDOCRINE TUMORS, best known for their ability to secrete bioactive peptides, which may cause symptoms such as flushing and diarrhea [1]. NETs classified as clinically symptomatic (functioning) or silent (nonfunctioning); both types frequently synthesize more than one peptide, although often these are not associated with specific syndromes [2]. As they being uncommon and may be nonspecific in their prentation, delays in diagnosis are frequent.

CASE PRESENTATION

A 62-year-old male known comorbid, presented in Oncology OPD with complaints of abdominal pain, nausea, vomiting and weight loss since 2 months. On examination, he had mild to moderate hepatomegaly almost 4 finger breadths from the costal margin with no tenderness, and the rest of the abdomen was soft with no distention or so. The rest of the systemic examination was normal. Investigations have been done to make the diagnosis.

RADIOLOGICAL FINDINGS-CT ABDOMEN WITH CONTRAST

The liver was enlarged with multiple hypodense areas (see Fig. 1). One of them was at anterior superior sub-segment viii with a lesion of 5.1x 2.1 cm with no intrahepatic biliary duct dilatation. There was abdominal lymphadenopathy with enlarged lymph nodes in the peripancreatic and mesenteric region-largest: 3.2 cm. There was minimal thickening of the pyloric end of the stomach.

BONE SCAN

Negative for any metastasis but arthritic changes in the left knee joint.

*Corresponding Author: Armeen Lakhani, Department of Oncology, Liaquat National Hospital and Medical College, Karachi, Pakistan; Email: armeenlakhani@yahoo.com

Received: October 02, 2020; Revised: February 03, 2021; Accepted: February 15, 2021 DOI: https://doi.org/10.37184/lntbj.2708-7808.2.12

Fig. (1): Enlarged liver with marked pointers as hypodense lesions

in liver.

ENDOSCOPIC FINDINGS

The patient had undergone EGD and Biopsy in which at the stomach there was a large irregular mass at the body of the stomach extending from lesser curvature to the pylorus (see Fig. 2). Multiple biopsies were taken.

HISTOPATHOLOGY DETAILS

The gastric growth biopsy showed individual cells with round nuclei with coarse chromatin and pale cytoplasm. The Immuno Histo Chemistry showing CK AE1/ AE 3 and SYNAPTOPHYSIN POSI-TIVE WITH Ki 67 of 10-

Fig. (2): Large irregular mass at the body of stomach, extending from

lesser curvature to pylorus.

Fig. (3): Nests of tumor cells with rounded nuclei showing coarse chromatin and pale cytoplasm.