Complex management of a long-term gastrinoma survivor with multimodal treatment approaches

#4497

Introduction: The prognosis of pancreatic gastrinomas is influenced by tumour burden, extent of metastasis, and treatment response, with 5-year survival rates ranging from 20% to 40%. Treatment for well-differentiated tumours typically include locoregional therapies, long-acting somatostatin analogues, molecular targeted agents, radionuclides, and chemotherapy.

Aim(s): This report presents the case of a long-term survivor of metastatic pancreatic gastrinoma, with a disease course spanning over 8 years. We aim to discuss the treatment strategies and tumour responses during this period, in correlation with the existing literature.

Materials and methods: We describe a 54-year-old obese smoker with a 10-year history of heartburn, pyrosis, and liquid diarrhoea prior to diagnosis. After a comprehensive workup and subsequent surgery, the final diagnosis was pancreatic gastrinoma with liver metastases (G2, Ki-67 5-10%), associated with Zollinger-Ellison syndrome. Over the course of the disease, the patient also developed bone and lymph node metastases. Treatment modalities included varying dosages and intervals of somatostatin analogues, chemotherapy regimens (capecitabine-temozolomide, cisplatin-based doublets, FOLFIRI), targeted therapy with sunitinib, and peptide receptor radionuclide therapy. This report discusses the rationale behind the therapeutic strategies employed and their correlation with tumour markers throughout the disease progression.

Conference:

Presenting Author: Puscasu A

Authors: Puscasu A, Miron M, Croitoru A,

Keywords: gastrinoma, neuroendocrine tumour, long survival, complex management,