A multidisciplinary approach to the management of gastroenteropancreatic neuroendocrine tumors - a case report

Introduction. Gastroenteropancreatic neuroendocrine tumors comprise a heterogeneous group of neoplasms that originate from the cells of the diffuse endocrine system within the gastrointestinal tract and pancreas. The diagnostic procedures and therapy of patients with gastroenteropancreatic neuroendocrine tumors is complex and requires a multidisciplinary approach. Case Report. A 51-year-old patient visited a Gastroenterology Outpatient Clinic for examination complaining of redness, facial swelling and frequent watery diarrhea since the age of 48 years. The clinical examination revealed subicterus, systolic murmur, and hepatomegaly. The patient received an extensive examination that included specific laboratory tests and various imaging techniques (endoscopy, radiology, cardiology, nuclear imaging) at the regional medical center. He was referred to a tertiary medical center, including the national Center for the Treatment of Neuroendocrine Tumors, and a metastatic neuroendocrine tumor, most likely affecting the ileum, was established. After preoperative cardiac and anesthesiological assessments, an elective surgical procedure was performed, with a pathohistological/immunohistochemical confirmation of a grade 1 neuroendocrine tumor of the ileum. Conclusion. The process of diagnosing gastroenteropancreatic neuroendocrine tumors, after the onset of symptoms, is often long, associated with comorbidities, and requires a multidisciplinary approach to diagnosis, treatment and monitoring.