177-Lutecio-DOTATE in the treatment of neuroendocrine rectal tumors with liver metastasis: case report

ABSTRACT

The present report describes a case of a neuroendocrine tumor of the rectum with liver metastasis in a 35-year-old woman. The rectum is the second most common location of gastrointestinal neuroendocrine tumors and is typically diagnosed through a screening colonoscopy finding for non-tumor related symptoms. Surgical treatment is indicated when the disease is localized, but, in most cases, this cancer is diagnosed in advanced stages. When advanced stages or metastasis is present, therapeutic include embolization, somatostatin analogs, interventional radiology and radiometabolic peptide therapy. 177-Lutecio-DOTATATE therapy has a positive impact on the quality of life of patients with inoperable metastatic tumors. The case descried was treated with surgery and later with liver segmentectomies, embolization, and octreotide due to liver tumor recurrence. With the persistence of the metastasis, started treatment with 177-Lutecio-DOTATATE. After the second cycle of administration, had partial remission of the tumor and symptoms.

RESUMO

O presente relato descreve um caso de tumor neuroendócrino do reto com metástase hepática em uma mulher de 35 anos. O reto é o segundo local mais comum de tumores neuroendócrinos gastrointestinais e é tipicamente diagnosticado através de um exame de colonoscopia para detectar sintomas não relacionados ao tumor. O tratamento cirúrgico é indicado quando a doença é localizada, mas, na maioria dos casos, esse câncer é diagnosticado em estágios avançados. Quando estágios avançados ou metástases estão presentes, as terapêuticas incluem embolização, análogos da somatostatina, radiologia intervencionista e terapia com peptídeos radiometabólicos. A terapia com Lutécio-177-DOTATATE tem um impacto positivo na qualidade de vida de pacientes com tumores metastáticos inoperáveis. O caso descrito foi tratado com cirurgia e posteriormente com segmentectomias hepáticas, embolização e octreotida devido à recorrência de tumores hepáticos. Com a persistência das metástases, iniciou-se o tratamento com Lutécio-177-DOTATATE. Após o segundo ciclo de administração, houve remissão parcial do tumor e sintomas.

Keywords:

Neuroendocrine tumors - Organometallic compounds - Octreotide - Rectal neoplasms

Descritores:

Tumores neuroendócrinos - Compostos organometálicos - Octreotida - Neoplasias retais

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