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Fujiwara S, Koyamada N, Miyazawa K, Saiki Y, Horii A, Miyazaki S. Duodenal neuroendocrine tumor after bilateral breast cancer with type 1 neurofibromatosis: a case report. Surg Case Rep 2024; 10:28. [PMID: 38282102 PMCID: PMC10822824 DOI: 10.1186/s40792-024-01827-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/19/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Young women with NF1 are at a high risk of developing breast cancer. Although they are at risk for abdominal tumors, such as gastrointestinal stromal tumors and neuroendocrine tumors, follow-up strategies for other tumors after breast cancer have not yet been established. Here, we present a case of duodenal neuroendocrine tumor found during follow-up after bilateral mastectomy for breast cancer with type 1 neurofibromatosis (NF1), for which pancreaticoduodenectomy (PD) and lymphadenectomy were performed. CASE PRESENTATION A 46-year-old woman with NF1 was referred to our hospital for treatment of a duodenal submucosal tumor. Her previous operative history included bilateral mastectomy for breast cancer: right total mastectomy and left partial mastectomy performed 9 and 5 years ago, respectively. Her daughter was confirmed to have NF1, but her parents were unclear. Although she had no recurrence or symptoms during the follow-up for her breast cancer, she wished to undergo 18-fluorodeoxyglucose-positron emission tomography (FDG-PET) for systemic screening. FDG-PET demonstrated FDG accumulation in the duodenal tumor with a maximum standardized uptake value of 5.78. Endoscopy revealed a 20-mm-diameter tumor in the second duodenal portion, and endoscopic biopsy suggested a NET G1. We performed PD and lymphadenectomy for complete. She was doing well without recurrence and was followed up with PET tomography-computed tomography. CONCLUSIONS Early detection of gastrointestinal tumors is difficult, because most of them are asymptomatic. Gastrointestinal screening is important for patients with NF1, and PD with lymphadenectomy is feasible for managing duodenal neuroendocrine tumors, depending on their size.
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Affiliation(s)
- Sho Fujiwara
- Department of Surgery, Iwate Prefectural Chubu Hospital, 17-10 Murasakino, Kitakami, , Iwate, 024-8507, Japan.
- Department of Molecular Pathology, Tohoku University School of Medicine, Sendai, Miyagi, 980-8575, Japan.
- Department of Surgery, Columbia University Irving Medical Center, 622 West 168th St, New York, NY, 10032, USA.
| | - Nozomi Koyamada
- Department of Surgery, Iwate Prefectural Chubu Hospital, 17-10 Murasakino, Kitakami, , Iwate, 024-8507, Japan
| | - Koji Miyazawa
- Department of Surgery, Iwate Prefectural Chubu Hospital, 17-10 Murasakino, Kitakami, , Iwate, 024-8507, Japan
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-0872, Japan
| | - Yuriko Saiki
- Department of Molecular Pathology, Tohoku University School of Medicine, Sendai, Miyagi, 980-8575, Japan
- Department of Investigative Pathology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan
- Office of Medical Education, Tohoku University School of Medicine, Sendai, Miyagi, 980-0872, Japan
| | - Akira Horii
- Department of Molecular Pathology, Tohoku University School of Medicine, Sendai, Miyagi, 980-8575, Japan
| | - Shukichi Miyazaki
- Department of Surgery, Iwate Prefectural Chubu Hospital, 17-10 Murasakino, Kitakami, , Iwate, 024-8507, Japan
- Department of Surgery, South Miyagi Medical Center, Ogawara, Shibata, Miyagi, 989-1253, Japan
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Hakozaki M, Fukuda H, Tajino T, Kikuchi S, Abe S, Konno S. Remitting seronegative symmetrical synovitis with pitting edema syndrome caused by crystal-induced arthritis of the wrist: a case report. Med Princ Pract 2013; 22:307-10. [PMID: 23006891 PMCID: PMC5586733 DOI: 10.1159/000342826] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 08/22/2012] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To describe a rare case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome caused by gouty arthritis. CLINICAL PRESENTATION AND INTERVENTION A 76-year-old man presented with swelling and pain in the dorsum of feet and hands bilaterally. From the laboratory and radiologic findings, the diagnosis of gout-induced RS3PE syndrome was made. Conservative therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and intra-articular corticosteroid injection in the wrist joint completely and rapidly resolved all symptoms. The patient was successfully treated with oral administration of NSAIDs and a one-time intra-articular corticosteroid injection in the left wrist joint. CONCLUSION This case demonstrated the importance of considering the possibility of crystal-induced arthritis such as gout and pseudogout, as well as malignant disease, when diagnosing the primary disease responsible for RS3PE syndrome.
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Affiliation(s)
- Michiyuki Hakozaki
- Department of Orthopaedic Surgery, Fukushima Prefectural Minami-Aizu Hospital, Fukushima, Japan.
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Sugisaki K, Hirose T. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome following spontaneous rupture of a gouty tophus. Mod Rheumatol 2008; 18:630-3. [PMID: 18688694 DOI: 10.1007/s10165-008-0105-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Accepted: 06/24/2008] [Indexed: 11/28/2022]
Abstract
A 70-year-old man with a 30-year history of gout presented with a ruptured gouty tophus over the right lateral malleolus. After the debridement of the tophus, bilateral arthralgia and pitting edema were observed in his extremities. Treatments with antibiotics and nonsteroidal antiinflammatory drugs were ineffective. However, prednisolone therapy was highly effective, and the patient's symptoms were rapidly ameliorated. Thus, we presume that rupture of a gouty tophus or its surgical treatment might contribute to the occurrence of RS3PE syndrome; however, in our case, the etiology of the syndrome remained unknown.
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Affiliation(s)
- Kota Sugisaki
- Division of Rheumatology, Jusendo General Hospital, 1-8-16 Ekimae, Koriyama, Fukushima, 963-8585, Japan.
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