scholarly journals Pre-therapy Somatostatin Receptor-Based Heterogeneity Predicts Overall Survival in Pancreatic Neuroendocrine Tumor Patients Undergoing Peptide Receptor Radionuclide Therapy

2018 ◽  
Vol 21 (3) ◽  
pp. 582-590 ◽  
Author(s):  
Rudolf A. Werner ◽  
Harun Ilhan ◽  
Sebastian Lehner ◽  
László Papp ◽  
Norbert Zsótér ◽  
...  
Keyword(s):  
Overall Survival ◽  
Neuroendocrine Tumor ◽  
Radionuclide Therapy ◽  
Somatostatin Receptor ◽  
Peptide Receptor Radionuclide Therapy ◽  
Pancreatic Neuroendocrine Tumor ◽  
Tumor Patients ◽  
Peptide Receptor

scholarly journals Efficacy of Peptide Receptor Radionuclide Therapy in a United States–Based Cohort of Metastatic Neuroendocrine Tumor Patients

Pancreas ◽  
2017 ◽  
Vol 46 (9) ◽  
pp. 1121-1126 ◽  
Author(s):  
Bryson W. Katona ◽  
Giorgio A. Roccaro ◽  
Michael C. Soulen ◽  
Yu-Xiao Yang ◽  
Bonita J. Bennett ◽  
...  
Keyword(s):  
United States ◽  
Neuroendocrine Tumor ◽  
Radionuclide Therapy ◽  
Peptide Receptor Radionuclide Therapy ◽  
Tumor Patients ◽  
Peptide Receptor ◽  
Metastatic Neuroendocrine Tumor

scholarly journals Peptide receptor radionuclide therapy controls inappropriate calcitriol secretion in a pancreatic neuro-endocrine tumor: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Maarten Haemels ◽  
Thierry Delaunoit ◽  
Koen Van Laere ◽  
Eric Van Cutsem ◽  
Chris Verslype ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Neuroendocrine Tumor ◽  
Neuroendocrine Tumors ◽  
Serum Calcium ◽  
Radionuclide Therapy ◽  
Active Form ◽  
Peptide Receptor Radionuclide Therapy ◽  
Pancreatic Neuroendocrine Tumor ◽  
Neuroendocrine Neoplasm ◽  
Peptide Receptor

Abstract Background Hypercalcemia of malignancy is not uncommon in patients with advanced stage cancer. In rare cases the cause of the hypercalcemia is excessive production of calcitriol, the active form of vitamin D. Although inappropriate tumoral secretion of calcitriol is typically associated with lymphomas and some ovarian germ cell tumors, we present a case of calcitriol overproduction-induced hypercalcemia due to a pancreatic neuroendocrine tumor. The high expression of somatostatin receptors on this neuroendocrine neoplasm opened up the opportunity to treat the patient with radiolabelled somatostatin analogs, which successfully controlled the refractory hypercalcaemia and calcitriol levels. This case documents a rare finding of refractory hypercalcaemia of underlying malignancy due to a calcitriol-producing pancreatic neuroendocrine tumor, responding to peptide receptor radionuclide therapy (PRRT). Case presentation A 57 years-old patient presented with back pain, general discomfort, polydipsia, polyuria, fatigue and recent weight loss of 10 kg. Clinical examination was normal and there was no relevant medical history. Biochemical evaluation showed hypercalcemia with markedly increased calcitriol levels. CT-thorax-abdomen and ultrasound guided biopsy revealed a pancreatic neuroendocrine tumor with multifocal liver metastases, suggesting that excessive overproduction of calcitriol by this neuroendocrine tumor was the cause of the refractory hypercalcemia. The patient was eligible for PRRT. Four cycles of 177Lu-DOTATATE PRRT resulted in a morphological response and a normalization of serum calcium levels, confirming the hypothesis of a calcitriol producing pancreatic neuroendocrine tumor. Progression of liver metastases warranted further therapy and temozolomide-capecitabine was started with morphological and biochemical (serum calcium, calcitriol) stabilization. Conclusion Although up to 30–40% of gastroenteropancreatic neuroendocrine tumors are known to be functional (i.e. producing symptoms associated with the predominant hormone/peptide secreted), calcitriol secreting pancreatic neuroendocrine tumors are very rare. However, treatment with PRRT resulted in normalization of calcium and calcitriol levels, strongly supporting the hypothesis of a calcitriol-producing pancreatic neuroendocrine tumor.

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