Severe gastroduodenal ulceration following radioactive microspheres treatment in a woman with metastatic neuroendocrine tumor: A case report of paradoxical microsphere migration

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Introduction: Incidence of liver metastasis (LM) in advanced NET is high and associated with poor prognosis. SIR-spheres for non-resectable LM in GEP NETs offers symptom regression and survival benefit. Complications are usually local given the SIR-spheres are delivered directly into the hepatic arteries and give off beta emitting radiation. Off target digression of microspheres to other tissues via hepaticoenteric arteries however can result in nearby organ damage.

Aim(s): A case of a 48-year-old woman with liver predominant metastatic grade 1 pancreatic NET whom experienced severe radiation gastroduodenitis following SIR-spheres despite appropriate work up, prophylactic embolization of the gastroduodenal artery and negative MAA breakthrough imaging.

Materials and methods: Delivery of SIR-spheres to the right and left hepatic arteries was uncomplicated, with no visible reflux intra-operatively and the post procedure Bremsstrahlung scan confirming appropriate distribution with no extrahepatic uptake.

Conference:

Presenting Author:

Authors: Smith A, Price T, Kitchener M, Trochsler M,

Keywords: SIR-spheres, microspheres, NET,