Neuroendocrine tumor of the small intestine: case report

Abstract

Background: Neuroendocrine tumor (NET) is an epithelial neoplasm with predominant neuroendocrine differentiation, considered rare, corresponding to only 3% of neoplasms of the gastrointestinal tract. Due to its rarity, it is diagnosed late, which can result in a worse prognosis. Aim: To report a case of a neuroendocrine tumor of the gastrointestinal tract operated in our department.

Method: This was a patient treated at the Hospital Universitário São Francisco na Providência de Deus (HUSF), located in the city of Bragança Paulista – SP, Brazil.

Case Report: ALS, a 52-year-old female, previously healthy, attended the emergency room with intermittent colicky epigastric pain radiating to the left flank for 2 months, associated with 18% weight loss and altered stools. A CT scan of the abdomen revealed liver lesions suspicious for malignancy, and a lobulated solid expansive formation centered on the left mesenteric root with involvement of the jejunal loop. The patient underwent exploratory laparotomy, in which a 4 cm lesion was located in the mesenteric root at 240 cm from Treitz's angle, with infiltration of the adjacent small bowel, 3 liver lesions and peritoneal implants. It was resected with surgical margins and sent for anatomopathology, with results compatible with neuroendocrine tumor of the small intestine, immunohistochemistry of grade I neuroendocrine tumor - NET GI.

Conclusion: In the case described, the delay in seeking health care, coupled with the rarity of small bowel tumors, led to a late diagnosis, with advanced disease. After surgery, the patient began adjuvant treatment with chemotherapy and is being followed up. Case reports of this type demonstrate the importance of suspecting small bowel tumors even in the face of generic symptoms, which can lead to a change in their diagnosis and incidence.