Downstaging and R0 resection of initially unresectable metastatic well-differentiated grade-3 pancreatic neuroendocrine tumor: a case report.

Houbiers, Arthur;Weerts, Joseph;Houbiers, Ghislain;Materne, Roland;Borbath, Ivan;et.al.
(2025) Acta Chirurgica Belgica (Bilingual Edition) — Vol. 125, n° 4, p. 215-221 (2025)

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Authors
  • Houbiers, Arthurorcid-logo
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  • Weerts, Joseph
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  • Houbiers, Ghislain
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  • Materne, Roland
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  • Borbath, IvanUCLouvain
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Abstract
(en) INTRODUCTION: High-grade pancreatic neuroendocrine tumors are rare, and most of them are well differentiated. Management of this type of tumor is not yet well established. METHODS: A 28-year-old woman was referred to our hospital for a well-differentiated grade-3 pancreatic neuroendocrine tumor with multiple liver metastases. The patient received neoadjuvant therapy consisting of combination of Capecitabine/Temozolomide chemotherapy and somatostatin analogue. RESULTS: An excellent regression was observed on both pancreatic and hepatic lesions, and therefore, an aggressive surgical management could be performed with a two-step scheme. Adjuvant hormono-chemotherapy was administered between the two surgeries. The patient achieved six years of disease-free survival following the last therapy. DISCUSSION AND CONCLUSION: We highlight the difference between well and poorly differentiated high-grade neuroendocrine neoplasia and report that aggressive surgery is a valid option even in metastatic presentation at diagnosis.
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Houbiers, A., Weerts, J., Houbiers, G., Materne, R., Witvrouw, N., Blétard, N., Monami, B., Focan, C., & Borbath, I. (2025). Downstaging and R0 resection of initially unresectable metastatic well-differentiated grade-3 pancreatic neuroendocrine tumor: a case report. Acta Chirurgica Belgica (Bilingual Edition), 125(4), 215-221. https://doi.org/10.1080/00015458.2025.2515325 (Original work published 2025)