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Multivisceral Transplantation and Vascularised Sentinel Forearm Flap for a Metastatic Small Bowel Neuroendocrine Tumour: Update on Follow-Up


Introduction: We previously reported the first documented case of a novel approach in a patient with extensive mesenteric metastases from a small bowel neuroendocrine tumour (SBNET): this combined multivisceral transplantation (MVT) and a vascularised sentinel forearm flap (VSFF) from the same donor.

Aim(s): We re-present this case after 40-month follow-up post-MVT/VSFF.

Materials and methods: A 44-year old male patient was diagnosed with a well-differentiated neuroendocrine tumour (G1, Ki67 <1%). Initial gut hormones were elevated: chromogranin A 395pmol/L (normal 0-60), chromogranin B 349 pmol/L (normal 0-150) and 24-hour urine 5-HIAA 643 µmol/L (normal 0-40). Pre-operative 68-Ga DOTATATE PET/CT revealed uptake in an aorto-caval lymph node and bulky mesenteric disease, which was confirmed at laparotomy as stage IV disease encasing the mesenteric root. Numerous lymph nodes and multifocal primary tumour (7 sub-centimetre lesions) were also found at surgery.

Conference: 14th Annual ENETSConcerence (2017)

Presenting Author: Frilling A

Authors: Frilling A, Giele H, Vrakas G, Reddy S, Macedo R,

Keywords: small bowel neuroendocrine tumour, multivisceral transplantation, forearm flap, follow-up,

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