Año 2023 / Volumen 115 / Número 12
Carta
Gastric variceal bleeding as a form of presentation of a pancreatic neuroendocrine tumor

735-736

DOI: 10.17235/reed.2023.9757/2023

Andrea García Soria, Alicia Brotons Brotons, Eva Girona Torres, Irene Pascual Sánchez, Asuncion Ojeda Gómez, Julia Sáez Fuster, Mariana Fe García Sepulcre, Javier Sola-Vera Sánchez,

Resumen
NETs (neuroendocrine tumors) constitute a heterogeneous group of epithelial-type neoplasms with a predominantly neuroendocrine differentiation. Although the most common locations are the pancreas, digestive tract, and lung, this type of neoplasm can arise in virtually any organ in the body. They are rare tumors with a wide variety of clinical presentations. Symptomatic tumors are more frequent in younger patients and present at more advanced pathological stages. We present the case of a 42-year-old male with idiopathic splenomegaly and bicytopenia (anaemia and thrombocytopenia) under study by haematology department who was admitted due to an episode of melena and hemoglobin of 4.5 mg/dl. Isolated gastric varices (IGV1) with red spots were confirmed at gastroscopy and endoscopic variceal obturation using cyanoacrylate was performed in two sessions. An endoscopic ultrasonography was performed, showing thrombosis of the splenic vein extending towards the splenoportal confluence with anechoic serpiginous structures outside and inside the gastric wall suggestive of collateral circulation with gastric varices (GV). An increase in portal caliber was observed, with no signs of liver cirrhosis. Computed tomography confirms the findings. Two months/week/days later he was readmitted with rebleeding signs after starting anticoagulant treatment, so it was decided to perform a splenectomy due to failure of the endoscopic treatment. Histology revealed infiltration of the spleen by a well-differentiated neuroendocrine tumor (NET). Gallium PET/CT and Octreotid scan showed uptake in the body and tail of the pancreas with positivity for somatostatin receptors previously undetected by other means. Finally, treatment was completed with distal pancreatectomy and splenoportal axis trombectomy with vascular esplenic resection and the patient was discharged from hospital.
Share Button
Nuevo comentario
Comentarios
No hay comentarios para este artículo.
Bibliografía
1. Raphael MJ, Chan DL, Law C et al. Principles of diagnosis and management of neuroendocrine tumours. CMAJ. 2017 Mar 13;189(10):E398-E404.
2. Ito T, Igarashi H, Jensen RT. Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances. Best Pract Res Clin Gastroenterol. 2012 Dec;26(6):737-53.
3. Hurtado-Pardo L, Breeze CE, Cienfuegos JA, Benito A, Valentí V, Martí-Cruchaga P, Zozaya G, Martínez Regueira F, Pardo F, Rotellar Sastre F. Comparison of phenotypes and outcomes following resection of incidental versus symptomatic pancreatic neuroendocrine tumors. Rev Esp Enferm Dig. 2022;114:317-322. doi: 10.17235/reed.2021.8096/2021.
4. Henry Z, Patel K, Patton H, Saad W. AGA clinical practice update on management of bleeding gastric varices: expert review. Clin Gastroenterol Hepatol. 2021;19(6):1098–1107.e1.
5. Hu Z, Zhang D, Swai J, Liu T, Liu S. Risk of rebleeding from gastroesophageal varices after initial treatment with cyanoacrylate; a systematic review and pooled analysis. BMC Gastroenterol. 2020 Jun 9;20(1):181. doi: 10.1186/s12876-020-01333-9. PMID: 32517718; PMCID: PMC7285616.
Artículos relacionados

Carta

Upper gastrointestinal bleeding and Rigler triad

DOI: 10.17235/reed.2023.9731/2023

Carta

Síndrome carcinoide y análogos de la somatostatina

DOI: 10.17235/reed.2023.9525/2023

Carta

A full hemostatic repertoire in a complex cirrhotic patient

DOI: 10.17235/reed.2022.9039/2022

Imagen en Patología Digestiva

Bezoar: an uncommon cause of upper gastrointestinal bleeding

DOI: 10.17235/reed.2021.8311/2021

Carta

COVID-19 and aorto-enteric fistula

DOI: 10.17235/reed.2021.8272/2021

Imagen en Patología Digestiva

Endoscopic resection of a duodenal neuroendocrine tumor

DOI: 10.17235/reed.2021.8232/2021

Imagen en Patología Digestiva

A rare cause of extrahepatic biliary tract stricture: a neuroendocrine carcinoma

DOI: 10.17235/reed.2020.6491/2019

Carta

Tumor neuroendocrino simulando un tumor de Klatskin

DOI: 10.17235/reed.2019.6382/2019

Carta al Editor

Tumores neuroendocrinos quísticos del páncreas

DOI: 10.17235/reed.2017.5390/2017

Carta al Editor

A case of a mixed adenoneuroendocrine tumor of the colon

DOI: 10.17235/reed.2017.5008/2017

Carta al Editor

Tumores neuroendocrinos de páncreas: claves para afrontar la heterogeneidad

DOI: 10.17235/reed.2017.4997/2017

Carta al Editor

Tumores neuroendocrinos de páncreas: factores pronósticos

DOI: 10.17235/reed.2017.5109/2017

Carta al Editor

Tumores neuroendocrinos pancreáticos

DOI: 10.17235/reed.2017.4725/2016

Editorial

Tumores neuroendocrinos del páncreas: no tan raros y no tan benignos

DOI: 10.17235/reed.2016.4672/2016

Carta al Editor

Una forma poco común de presentación de ictericia obstructiva

DOI: 10.17235/reed.2017.4501/2016

Carta al Editor

Gastric neuroendocrine tumor presenting with gastrointestinal bleeding

DOI: 10.17235/reed.2015.3998/2015

Instrucciones para citar
García Soria A, Brotons Brotons A, Girona Torres E, Pascual Sánchez I, Ojeda Gómez A, Sáez Fuster J, et all. Gastric variceal bleeding as a form of presentation of a pancreatic neuroendocrine tumor. 9757/2023


Descargar en un gestor de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica
Este artículo ha sido visitado 651 veces.
Este artículo ha sido descargado 50 veces.

Estadísticas de Dimensions


Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 30/05/2023

Aceptado: 17/07/2023

Prepublicado: 04/08/2023

Publicado: 12/12/2023

Tiempo de prepublicación: 66 días

Tiempo de edición del artículo: 196 días


Compartir
Este artículo aun no tiene valoraciones.
Valoración del lector:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
La REED es el órgano oficial de la Sociedad Española de Patología Digestiva, la SociedadEspañola de Endoscopia Digestiva y la Asociación Española de Ecografía Digestiva
Política de cookies Política de Privacidad Aviso Legal © Copyright 2023 y Creative Commons. Revista Española de Enfermedades Digestivas