Detecting rare pancreatic tumor after two months of severe depression – VnExpress

Two months lost 8 kg, severe weakness, digestive disorders, the patient was diagnosed with pancreatic tumor and improved treatment.

Patient Le Thi Van (62 years old, Thai Binh) presented with epigastric abdominal pain (between the ribs and under the nose of the sternum) with bloody stools, poor appetite a few months ago. At the beginning of April, she went to the doctor at the grassroots level and the doctor ordered her to monitor her at home, but her symptoms did not improve. Colonoscopy, abdominal ultrasound and suspicion of pancreatic injury.

Ms. Van would like to move to the upper line. The doctor continued to prescribe scans, blood tests, biopsies of many locations and organs of the liver, pancreas, colon… but the diagnosis was not clear. After two months of treatment, her health deteriorated, she was very tired, she ate poorly, and her body lost about 8 kg. Because the symptoms did not go away, the patient went to the Department of Gastroenterology – Hepatobiliary – Pancreas, Tam Anh General Hospital, Hanoi.

Doctor, Dr. Vu Truong Khanh, Head of the Department of Gastroenterology – Hepatobiliary – Pancreas, said that according to the computed tomography image of the abdomen, Ms. Van had a tumor in the tail of the pancreas (which is part of the digestive system and the digestive system). endocrine system) invades the splenic flexure colon, splenic hilum, splenic vascular bundle. Splenic vein thrombosis. The liver and spleen parenchyma have secondary damage. The results of thoracic examination showed that the patient also had lymph nodes in the abdomen and chest, suspected of having metastases from the pancreas.

Due to the elderly patient’s severe exhaustion, doctors confirmed the disease by biopsy with fine needles, under the guidance of endoscopic ultrasound (EUS).

According to Dr. Khanh, this high technique requires a team of highly specialized doctors to actively perform lesion exploration in difficult-to-biopsy locations such as the pancreas. The advantage of this method is that the patient is painless, does not bleed and can resume normal activities immediately after the biopsy. Through biopsy and pathology, the doctor concluded that neuroendocrine tumors in the pancreas were the cause of liver metastases, invading nearby organs such as the colon, causing thrombosis of the splenic vein and the mesenteric vein of the patient. … Pancreatic neuroendocrine tumors are rare in the world with an incidence of 3-10 people per million.

Dr. Khanh further explained that neuroendocrine tumors originate from specialized cells of the neuroendocrine system. These cells have the characteristics of hormone secreting cells and nerve cells, found throughout the body. Neuroendocrine tumors include many types with very different symptoms. Pancreatic neuroendocrine tumors are tumors that arise from the nerve or endocrine cells of the pancreas. About 40% of pancreatic neuroendocrine tumors have symptoms due to increased secretion of hormones causing diarrhea, sweating, hypoglycemia… More than 50% of cases have no symptoms. It is the difficulty in diagnosis that greatly affects the effectiveness of treatment and the patient’s health.

Doctor, Dr. Vu Truong Khanh shares information with patients. Image: Hospital provides

Mrs. Van was fed intravenously, received medical treatment with drugs suitable for her condition… After about 4 days, the patient’s condition was stable, no fever, no nausea, abdominal pain, etc. No more frequent bowel movements, soft abdomen, normal urination. Sleep is also better so the spirit is uplifted.

Because the disease progresses silently and for a long time, Dr. Khanh recommends that when there are abnormal symptoms such as abdominal pain, loss of appetite, nausea, digestive disorders… patients should go to the hospital for examination. Many subjective cases, self-monitoring at home or treatment at facilities have no signs of improvement, making the disease worse, and the effectiveness of diagnosis and treatment reduced.



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