Multidisciplinary surgical management with chemotherapy and transcatheter arterial embolization for a giant hypervascular pancreatic neuroendocrine tumor

Niwa, Kokoro; Takeuchi, Shintaro; Tsuchikawa, Takahiro; Nakamura, Toru; Takeuchi, Satoshi; Morita, Ryo; Abo, Daisuke; Hirata, Kenji; Mitsuhashi, Tomoko; Hirano, Satoshi

Multidisciplinary surgical management with chemotherapy and transcatheter arterial embolization for a giant hypervascular pancreatic neuroendocrine tumor

Niwa, Kokoro; Takeuchi, Shintaro; Tsuchikawa, Takahiro et al.

Clinical journal of gastroenterology, 2025, 19(1), 63-70

Permalink : https://hdl.handle.net/2115/98144

このアイテムのアクセス数:12件（2026-10-15 01:41 集計）

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アクセス権	open access
URI	https://hdl.handle.net/2115/98144
タイトル	Multidisciplinary surgical management with chemotherapy and transcatheter arterial embolization for a giant hypervascular pancreatic neuroendocrine tumor
著者	Niwa, Kokoro ; Takeuchi, Shintaro ; Tsuchikawa, Takahiro ; Nakamura, Toru ; Takeuchi, Satoshi ; Morita, Ryo ; Abo, Daisuke ; Hirata, Kenji ; Mitsuhashi, Tomoko ; Hirano, Satoshi
著者名 Niwa, Kokoro
著者名 Takeuchi, Shintaro
e-Rad_Researcher 50507572 著者名 Tsuchikawa, Takahiro
e-Rad_Researcher 70645796 著者名 Nakamura, Toru
著者名 Takeuchi, Satoshi
e-Rad_Researcher 30872626 著者名 Morita, Ryo
e-Rad_Researcher 30399844 著者名 Abo, Daisuke
e-Rad_Researcher 30431365 著者名 Hirata, Kenji
e-Rad_Researcher 60348208 著者名 Mitsuhashi, Tomoko
e-Rad_Researcher 50322813 著者名 Hirano, Satoshi
言語	英語
キーワード	Pancreatic neuroendocrine tumor
	Locally advanced
	Conversion surgery
	Transcatheter arterial embolization
	Multidisciplinary treatment
発行日	2025-09-30
出版者	Springer
収録物名	Clinical journal of gastroenterology
巻(号)	19(1)
ページ	63-70
抄録	Pancreatic neuroendocrine tumors (pNETs) are rare and heterogeneous neoplasms occasionally presenting as giant, hypervascular, and anatomically complex tumors. In such cases, curative resection is often challenging, and multidisciplinary treatment is required. However, the clinical utility and optimal sequencing for these approaches remain unclear. We report a 39-year-old woman with a 130 mm hypervascular pNET occupying nearly the entire pancreas, complicated by portal vein tumor thrombus (PVTT) and extensive collateral circulation. The tumor was initially deemed unresectable by a multidisciplinary team. Streptozotocin (STZ)-based chemotherapy led to tumor regression and PVTT resolution. Preoperative transcatheter arterial embolization (TAE) was subsequently performed to reduce arterial inflow and facilitate surgical manipulation. Total pancreatectomy with segmental portal vein resection was successfully performed without transfusions. Histopathological examination confirmed a grade 2 pNET with a multifocal histological response which was consistent with radiological findings. The patient remained recurrence-free for 12 months postoperatively without adjuvant therapy. This case highlights the clinical utility of integrating STZ-based chemotherapy and selective TAE to achieve curative surgery for locally advanced giant pNETs. The unique clinical course and radiologic-pathologic correlation of this rare disease further contribute to the understanding of the treatment response.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s12328-025-02232-w
PISSN	1865-7257
EISSN	1865-7265
関連情報	PMID 41023360
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s12328-025-02232-w