Login Register Cart 0
Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Case Report

The Evolution of Pancreatic Islet Function in a Diabetic Patient after Pancreatic Neuroendocrine Neoplasm Surgery: A Case Report

Author(s): Song Wen, Junhong Pan, Congying Liu, Xinlu Yuan, Congcong Wang, Qinghua You, Xinjiang Liu and Ligang Zhou*

Volume 23, Issue 7, 2023

Published on: 07 February, 2023

Page: [984 - 991] Pages: 8

DOI: 10.2174/1871530323666221216143320

Price: $65

Abstract

Background: Pancreatic neuroendocrine neoplasms (pNENs) are rare primary tumors of the pancreas. Although these tumors are heterogeneous and can be classified as functional or non-functional according to pancreatic endocrine biomarkers, the more prevalent type is non-functional pNENs with endocrine differentiation but with non-specific symptoms and often late diagnoses. The treatment option for patients often involves surgical management, but the reported outcomes, especially on insulin secretion change and the trend of diabetes in these patients, varied to date. Hence, the purpose of this clinical report is to study the functional change of pancreatic β- cell corresponding to the mass of tumorectomy of pNEN in a diabetic patient.

Case Presentation: We reported that a 39-year-old man with diabetes was found complicated with neuroendocrine neoplasm. He was admitted to the General Surgery of our hospital for further examination and therapy. The patient received a pancreatectomy + splenectomy + lymphadenectomy on the pancreatic body and tail. We analyzed the pancreatic mass change and performed Oral Glucose Tolerance Test (OGTT) before and after the surgery to evaluate the function of the pancreas.

Conclusion: This case may provide us a reference to predict the extent of islet function loss before the pancreatectomy, and apply personalized hypoglycemic therapy after surgery in these patients.

« Previous Next »
Graphical Abstract

[1]
Alexandraki, K.I.; Spyroglou, A.; Kykalos, S.; Daskalakis, K.; Kyriakopoulos, G.; Sotiropoulos, G.C.; Kaltsas, G.A.; Grossman, A.B. Changing biological behaviour of NETs during the evolution of the disease: Progress on progression. Endocr. Relat. Cancer, 2021, 28(5), R121-R140.
[http://dx.doi.org/10.1530/ERC-20-0473] [PMID: 33827047]
[2]
Alexakis, N.; Neoptolemos, J.P. Pancreatic neuroendocrine tumours. Best Pract. Res. Clin. Gastroenterol., 2008, 22(1), 183-205.
[http://dx.doi.org/10.1016/j.bpg.2007.10.008] [PMID: 18206821]
[3]
Rindi, G.; Mete, O.; Uccella, S.; Basturk, O.; La Rosa, S.; Brosens, L.A.A.; Ezzat, S.; de Herder, W.W.; Klimstra, D.S.; Papotti, M.; Asa, S.L. Overview of the 2022 WHO classification of neuroendocrine neoplasms. Endocr. Pathol., 2022, 33(1), 115-154.
[http://dx.doi.org/10.1007/s12022-022-09708-2] [PMID: 35294740]
[4]
Singhi, A.D.; Klimstra, D.S. Well-differentiated pancreatic neuroendocrine tumours (PanNETs) and poorly differentiated pancreatic neuroendocrine carcinomas (PanNECs): Concepts, issues and a practical diagnostic approach to high-grade (G3) cases. Histopathology, 2018, 72(1), 168-177.
[http://dx.doi.org/10.1111/his.13408] [PMID: 29239037]
[5]
Landoni, L.; Marchegiani, G.; Pollini, T.; Cingarlini, S.; D’Onofrio, M.; Capelli, P.; De Robertis, R.; Davì, M.V.; Amodio, A.; Impellizzeri, H.; Malpaga, A.; Miotto, M.; Boninsegna, L.; Crepaz, L.; Nessi, C.; Zingaretti, C.C.; Paiella, S.; Esposito, A.; Casetti, L.; Malleo, G.; Tuveri, M.; Butturini, G.; Salvia, R.; Scarpa, A.; Falconi, M.; Bassi, C. The evolution of surgical strategies for Pancreatic Neuroendocrine Tumors (Pan-NENs). Ann. Surg., 2019, 269(4), 725-732.
[http://dx.doi.org/10.1097/SLA.0000000000002594] [PMID: 29189384]
[6]
de Ponthaud, C.; Menegaux, F.; Gaujoux, S. Updated principles of surgical management of Pancreatic Neuroendocrine Tumours (pNETs): What every surgeon needs to know. Cancers, 2021, 13(23), 5969.
[http://dx.doi.org/10.3390/cancers13235969] [PMID: 34885079]
[7]
Park, S.Y.; Park, K.M.; Shin, W.Y.; Choe, Y.M.; Hur, Y.S.; Lee, K.Y.; Ahn, S.I. Functional and morphological evolution of remnant pancreas after resection for pancreatic adenocarcinoma. Medicine, 2017, 96(28), e7495.
[http://dx.doi.org/10.1097/MD.0000000000007495] [PMID: 28700497]
[8]
Neves, J.S.; Teles, L.; Guerreiro, V.; Lau, E.; Oliveira, A.I.; Graça, L.; Lopes, J.M.; Freitas, P.; Carvalho, D. Clinical characteristics and incidence of glucose metabolism disorders during the follow-up of surgically treated insulinomas. Endocrine, 2021, 71(2), 351-356.
[http://dx.doi.org/10.1007/s12020-020-02520-0] [PMID: 33068253]
[9]
Wen, S.; Wang, C.; Gong, M.; Zhou, L. An overview of energy and metabolic regulation. Sci. China Life Sci., 2019, 62(6), 771-790.
[http://dx.doi.org/10.1007/s11427-018-9371-4] [PMID: 30367342]
[10]
Young, M.C.; Theis, J.R.; Hodges, J.S.; Dunn, T.B.; Pruett, T.L.; Chinnakotla, S.; Walker, S.P.; Freeman, M.L.; Trikudanathan, G.; Arain, M.; Robertson, P.R.; Wilhelm, J.J.; Schwarzenberg, S.J.; Bland, B.; Beilman, G.J.; Bellin, M.D. Preoperative computerized tomography and magnetic resonance imaging of the pancreas predicts pancreatic mass and functional outcomes after total pancreatectomy and islet autotransplant. Pancreas, 2016, 45(7), 961-966.
[http://dx.doi.org/10.1097/MPA.0000000000000591] [PMID: 26745861]
[11]
Wen, K.; Cen, C.; Wu, L.; Huang, M.; Yang, H.; Yue, X.; Zhang, Y.; Ma, G.; Li, X.; Han, P. Relationship between pancreatic parenchyma loss and early postoperative hyperglycemia in patients with benign pancreatic diseases. Abdom. Radiol., 2021, 46(9), 4210-4217.
[http://dx.doi.org/10.1007/s00261-021-03061-4] [PMID: 33813625]
[12]
Friederich, E.; Pringault, E.; Arpin, M.; Louvard, D. From the structure to the function of villin, an actin-binding protein of the brush border. BioEssays, 1990, 12(9), 403-408.
[http://dx.doi.org/10.1002/bies.950120902] [PMID: 2256904]
[13]
Chen, X.; Guo, C.; Cui, W.; Sun, K.; Wang, Z.; Chen, X. CD56 expression is associated with biological behavior of pancreatic neuroendocrine neoplasms. Cancer Manag. Res., 2020, 12, 4625-4631.
[http://dx.doi.org/10.2147/CMAR.S250071] [PMID: 32606955]
[14]
Tomita, T. Significance of chromogranin A and synaptophysin in pancreatic neuroendocrine tumors. Bosn. J. Basic Med. Sci., 2020, 20(3), 336-346.
[http://dx.doi.org/10.17305/bjbms.2020.4632] [PMID: 32020844]
[15]
Mahata, S.K.; Corti, A. Chromogranin A and its fragments in cardiovascular, immunometabolic, and cancer regulation. Ann. N. Y. Acad. Sci., 2019, 1455(1), 34-58.
[http://dx.doi.org/10.1111/nyas.14249] [PMID: 31588572]
[16]
Rosenberg, M.; Fuchs, E.; Le Beau, M.M.; Eddy, R.L.; Shows, T.B. Three epidermal and one simple epithelial type II keratin genes map to human chromosome 12. Cytogenet. Genome Res., 1991, 57(1), 33-38.
[http://dx.doi.org/10.1159/000133109] [PMID: 1713141]
[17]
Vanoli, A.; Albarello, L.; Uncini, S.; Fassan, M.; Grillo, F.; Di Sabatino, A.; Martino, M.; Pasquali, C.; Milanetto, A.C.; Falconi, M.; Partelli, S.; Doglioni, C.; Schiavo-Lena, M.; Brambilla, T.; Pietrabissa, A.; Sessa, F.; Capella, C.; Rindi, G.; La Rosa, S.; Solcia, E.; Paulli, M. Neuroendocrine tumors (NETs) of the minor papilla/ampulla. Am. J. Surg. Pathol., 2019, 43(6), 725-736.
[http://dx.doi.org/10.1097/PAS.0000000000001234] [PMID: 30913089]
[18]
Moll, R.; Divo, M.; Langbein, L. The human keratins: Biology and pathology. Histochem. Cell Biol., 2008, 129(6), 705-733.
[http://dx.doi.org/10.1007/s00418-008-0435-6] [PMID: 18461349]
[19]
Notohara, K.; Hamazaki, S.; Tsukayama, C.; Nakamoto, S.; Kawabata, K.; Mizobuchi, K.; Sakamoto, K.; Okada, S. Solid-pseudopapillary tumor of the pancreas: Immunohistochemical localization of neuroendocrine markers and CD10. Am. J. Surg. Pathol., 2000, 24(10), 1361-1371.
[http://dx.doi.org/10.1097/00000478-200010000-00005] [PMID: 11023097]
[20]
Scholzen, T.; Gerdes, J. The Ki-67 protein: From the known and the unknown. J. Cell. Physiol., 2000, 182(3), 311-322.
[http://dx.doi.org/10.1002/(SICI)1097-4652(200003)182:3<311:AID-JCP1>3.0.CO;2-9] [PMID: 10653597]
[21]
Ahn, B.; Jung, J.K.; Jung, H.; Ryu, Y.M.; Kim, Y.W.; Song, T.J.; Park, D.H.; Hwang, D.W.; Cho, H. Kim, SY Double Ki-67 and synaptophysin labeling in pancreatic neuroendocrine tumor biopsies. Pancreatology, 2022, 22(3), 427-434.
[http://dx.doi.org/10.1016/j.pan.2022.03.005]
[22]
Gould, V.E.; Wiedenmann, B.; Lee, I.; Schwechheimer, K.; Dockhorn-Dworniczak, B.; Radosevich, J.A.; Moll, R.; Franke, W.W. Synaptophysin expression in neuroendocrine neoplasms as determined by immunocytochemistry. Am. J. Pathol., 1987, 126(2), 243-257.
[PMID: 3103452]
[23]
Permert, J.; Herrington, M.; Kazakoff, K.; Pour, P.M.; Adrian, T.E. Early changes in islet hormone secretion in the hamster pancreatic cancer model. Teratog. Carcinog. Mutagen., 2001, 21(1), 59-67.
[http://dx.doi.org/10.1002/1520-6866(2001)21:1<59:AID-TCM6>3.0.CO;2-V] [PMID: 11135321]
[24]
Singbo, J.; Locketz, M.; Ross, I.L. Challenge of coexisting type 2 diabetes mellitus and insulinoma: A case report. J. Med. Case Reports, 2021, 15(1), 479.
[http://dx.doi.org/10.1186/s13256-021-03047-2] [PMID: 34583764]
[25]
Jilesen, A.P.J.; van Eijck, C.H.J.; Busch, O.R.C.; van Gulik, T.M.; Gouma, D.J.; van Dijkum, E.J.M.N. Postoperative outcomes of enucleation and standard resections in patients with a pancreatic neuroendocrine tumor. World J. Surg., 2016, 40(3), 715-728.
[http://dx.doi.org/10.1007/s00268-015-3341-9] [PMID: 26608956]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy