LONG-TERM FOLLOW-UP OF PATIENTS UNDERGOING ENDOSCOPIC PAPILLECTOMY FOR PAPILLARY NEUROENDOCRINE TUMOR: A CASE SERIES AND LITERATURE REVIEW

Seguimento de longo prazo de pacientes com tumor neuroendócrino da papila duodenal submetidos à papilectomia endoscópica: série de casos e revisão da literatura

ABSTRACT

BACKGROUND:

Duodenal papilla neuroendocrine tumors (DP-NET) are rare. Surgical therapy may be recommended for their treatment. However, they have high rates of morbidity and mortality. Endoscopic papillectomy (EP) is safe and effective for complete resection of tumors at this site.

OBJECTIVE:

This study aimed to describe a case series of DP-NETs resected by EP and perform a literature review.

METHODS:

A series of patients with DP-NETs underwent EP as primary treatment between Jan/2008 and Mar/2020 at a tertiary referral center. A comprehensive search was made on the MEDLINE primary electronic database. The search strategy was designed to find all articles related to DP-NETs published in the literature.

RESULTS:

Six patients underwent EP for presenting DP-NETs, four of whom were women (mean age, 63 years). The mean diameter of DP-NETs was 1.6±0.3 cm. Four of six patients were followed up, one of whom suffered relapse at the resection site after 3 months and was referred to surgery (pT3n1b) and the remaining three patients experienced no endoscopic or histological recurrence during follow-up periods of 10, 7, and 4 years, respectively. Eighteen articles were found in the literature search in MEDLINE. The articles included case reports of endoscopically treated DP-NETs.

CONCLUSION:

EP is safe and effective for DP-NETs that are ≤20 mm, confined to the submucosal layer, well-differentiated, and without local or remote metastasis. Adequate endoscopic follow-up and definitive surgical treatment in the presence of relapse are necessary.

Keywords:
Neuroendocrine tumors; endoscopic papillectomy; endoscopic ultrasonography; duodenal papilla; ampulla of Vater; endoscopic treatment; diagnosis