Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 14, 2009; 15(46): 5867-5870
Published online Dec 14, 2009. doi: 10.3748/wjg.15.5867
Neoadjuvant peptide receptor radionuclide therapy for an inoperable neuroendocrine pancreatic tumor
Daniel Kaemmerer, Vikas Prasad, Wolfgang Daffner, Dieter Hörsch, Günter Klöppel, Merten Hommann, Richard P Baum
Daniel Kaemmerer, Wolfgang Daffner, Merten Hommann, Department of General and Visceral Surgery, Zentralklinik Bad Berka, 99437 Bad Berka, Germany
Vikas Prasad, Richard P Baum, Department of Nuclear Medicine, Center for PET, Zentralklinik Bad Berka, 99437 Bad Berka, Germany
Dieter Hörsch, Department of Internal Medicine, Gastroenterology, Endocrinology and Oncology, Zentralklinik Bad Berka, 99437 Bad Berka, Germany
Günter Klöppel, Department of Pathology, University of Kiel, 24105 Kiel, Germany
Author contributions: Kaemmerer D researched the case, analyzed the data and wrote the paper; Prasad V and Baum RP performed the PRRT as neoadjuvant approach; Hommann M, Daffner W and Kaemmerer D accomplished the operation; Klöppel G and Hörsch D investigated the histology and critically revised the paper.
Correspondence to: Dr. Daniel Kaemmerer, Department of General and Visceral Surgery, Zentralklinik Bad Berka, 99437 Bad Berka, Germany.
Telephone: +49-364-5852700 Fax: +49-364-5853536
Received: August 26, 2009
Revised: October 26, 2009
Accepted: November 2, 2009
Published online: December 14, 2009

Pancreatic endocrine tumors are rare but are among the most common neuroendocrine neoplasms of the abdomen. At diagnosis many of them are already advanced and difficult to treat. We report on an initially inoperable malignant pancreatic endocrine tumor in a 33-year-old woman, who received neoadjuvant peptide receptor radionuclide therapy (PRRT) as first-line treatment. This resulted in a significant downstaging of the tumor and allowed its subsequent complete surgical removal. Follow-up for eighteen months revealed a complete remission. This is the first report on neoadjuvant PRRT in a neuroendocrine neoplasm with subsequent successful complete resection.

Keywords: Endocrine pancreatic carcinoma, Peptide receptor radionuclide therapy, Neodjuvant treatment, Pancreatic surgery, Molecular imaging, Receptor pancreatic endocrine tumor, Computed tomography