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第二次恶性瘤伪装成神经内分泌瘤的复发
Ananda Mohan Chakraborty1, Neha Bhardwaj2, Ashu Rastogi1
1Department of Endocrinology, PGIMER, Chandigarh 160012, India.
JCEM case reports
|January 29, 2024
概括
对神经内分泌瘤 (NETs) 的放射治疗可以导致二次肺癌. 一名患有由于支气管NET引起的库辛综合征的患者在治疗后发展出一种罕见的,侵袭性的粘膜皮质瘤,突出显示了辐射风险.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 辐射瘤学 辐射瘤学
背景情况:
- 神经内分泌瘤 (NETs) 可以通过异位ACTH分泌引起诸如库辛综合征 (CS) 等内分泌综合征.
- 放射治疗 (RT) 是一种常见的辅助治疗持续性或复发性NETs.
- 潜在的RT风险之一是诱导二次恶性瘤.
研究的目的:
- 报告一个罕见的肺部神经内分泌瘤放射治疗后的二次恶性瘤病例.
- 突出在NET患者的辅助放射治疗相关的潜在的长期风险.
主要方法:
- 一个37岁的男性病例报告,有支气管NET病史,导致CS.
- 对临床表现,诊断工作,治疗史和结果的审查.
- 切除的肺部质量的组织病理学检查.
主要成果:
- 该患者此前曾因支气管NET与CS接受过治疗,出现了暗示复发的症状.
- 活检揭示了高度粘膜皮质癌 (MEC),这是一个罕见的肺癌,而不是NET复发.
- 患者屈服于攻击性的二次MEC,尽管原发性NET和CS的缓解.
结论:
- 这一病例代表了首次报告的肺粘膜皮质癌在RT后发展为支气管NET引起异位CS的病例.
- 对NET的辅助放射治疗虽然有益,但存在二次恶性瘤的风险,这些恶性瘤可能是侵略性的和致命的.
- 对于接受RT为NET治疗的患者来说,仔细的长期监测至关重要,以早期检测二次癌症.
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