Case Reports Journal Article Epublish
PubMed: 40641634 DOI: 10.1530/EO-25-0033
Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATE.
Endocr Oncol 5(1):e250033
Authors: Eleonora Pelle, Taymeyah Al-Toubah, Ghassan El-Haddad, Brian Morse, Bhavana Konda, Vineeth Sukrithan, Jonathan Strosberg
Affiliations
- Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
- Department of Diagnostic Imaging and Interventional Radiology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
- Division of Medical Oncology, Department of Internal Medicine, Ohio State University College of Medicine, Columbus, Ohio, USA.
Abstract
Background
Lutetium-177 ( 177Lu)-DOTATATE is an effective treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors, which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritoneal disease has been described. We investigated the potential for intestinal ischemia in 177Lu-DOTATATE-treated patients.
Methods
Clinical records were reviewed of patients with midgut NETs treated with 177Lu-DOTATATE at the Moffitt Cancer Center between April 2018 and December 2022 and at The Ohio State University between December 2017 and October 2020.
Results
Among the cases reviewed, we identified three patients who developed bowel ischemia/perforation shortly after their initial treatment with 177Lu-DOTATATE. All patients had metastatic small bowel NET with prominent mesenteric mass encasing/obstructing the mesenteric vessels and preexisting symptoms of postprandial abdominal pain.
Conclusion
Acute bowel ischemia may be a rare complication of PRRT in patients with mesenteric arterial or venous obstruction from mesenteric metastasis.
MeSH
Neoplasms, Aftercare, Neuroendocrine Tumors, Therapeutics, Ischemia