An Unusual Case of Chronic Diarrhea due to a Hidden Neuroendocrine Tumor

Carola Maria Gagliardo#, Davide Noto*#, Antonina Giammanco, Rosalia Lo Presti, Annalisa Savoja, Marcella Panzica, Giuseppe Lavatura and Maurizio Averna

Department of Health Promotion, Maternal and Child Health, Internal and Specialised Medicine of Excellence "G. D. Alessandro" (PROMISE), University of Palermo, Italy   #These authors contributed equally to this work

^*Correspondance to: Davide Noto 

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Abstract:

Gastroenteropancreatic-Neuroendocrine Neoplasms (GEP-NEN) are a heterogeneous group of rare tumors with annual incidence of less than 5 cases per 100,000 inhabitants. GEP-NEN is often mistaken for other disorders. The primary cancer site is unknown in about 13% of patients diagnosed with GEP-NEN. We report a case of a 71-years Caucasic old man, admitted at the Internal medicine unit because of a chronic intermittent watery diarrhea. Extensive laboratory analysis, imaging and colonoscopy were not helpful to make a diagnosis. Plasma levels of chromogranin A were elevated; metanephrines, normetanephrines, urinary 5-hydroxy indolacetic acid were within the normal range. The chromogranin values prompted the suspicion of GEP-NEN, and then a 68Gallium-DOTATOC PET/CT was performed. The imaging exams showed a 9 mm-diameter nodule expressing somatostatin SSTR2-5 receptors, localized in the peripancreatic adipose tissue that we diagnosed as a GEP-NEN.

Keywords:

GEP-NEN; Diarrhea; 68Gallium-Dotatoc PET/CT; Chromogranin A

Cite the Article:

Gagliardo CM, Noto D, Giammanco A, Presti RL, Savoja A, Panzica M, et al. An Unusual Case of Chronic Diarrhea due to a Hidden Neuroendocrine Tumor. Ann Clin Case Rep. 2022; 7: 2171..