Mesenteric Variceal Haemorrhage and Ectopic Cushing’s Syndrome as Presenting Features of a Pancreatic Neuroendocrine Tumour Recurrence

Pancreatic neuroendocrine tumours can have varied and complex presentations. Whilst hormone hypersecretion often induces characteristic clinical syndromes, non-specific symptoms may arise due to localized tumour effects. Malignant invasion of local vasculature is an increasingly recognized complicat...

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Autores principales:	Scott Weerasuriya, Kieran Palmer, Stephen Gregory, Benjamin C. Whitelaw, Elisa Gonzalez, Rajaventhan Srirajaskanthan
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	cushing’s syndrome ectopic varices gastrointestinal bleeding neuroendocrine carcinoma pancreatic cancer portal hypertension Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/12104711115b43fd8f1b2b08de5b1d1b
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spelling	oai:doaj.org-article:12104711115b43fd8f1b2b08de5b1d1b2021-11-11T10:40:44ZMesenteric Variceal Haemorrhage and Ectopic Cushing’s Syndrome as Presenting Features of a Pancreatic Neuroendocrine Tumour Recurrence1662-063110.1159/000518021https://doaj.org/article/12104711115b43fd8f1b2b08de5b1d1b2021-10-01T00:00:00Zhttps://www.karger.com/Article/FullText/518021https://doaj.org/toc/1662-0631Pancreatic neuroendocrine tumours can have varied and complex presentations. Whilst hormone hypersecretion often induces characteristic clinical syndromes, non-specific symptoms may arise due to localized tumour effects. Malignant invasion of local vasculature is an increasingly recognized complication of these neoplasms and can be associated with significant morbidity. Herein, we present the case of a 47-year-old male with a recurrence of a pancreatic neuroendocrine tumour who presented with unusual upper gastrointestinal bleeding. The tumour had recurred within the superior mesenteric vein, replacing the vessel and invading its branches. This resulted in porto-mesenteric hypertension and the formation of bleeding mesenteric varices. The patient subsequently developed progressive metabolic disturbances and was diagnosed with ectopic Cushing’s syndrome, despite his primary tumour having been non-functional. This case demonstrates not only a rare pattern of tumour recurrence but also the potential for pancreatic neuroendocrine tumours to de-differentiate and change from non-functional to hormone secreting, a phenomenon which may complicate diagnosis and management.Scott WeerasuriyaKieran PalmerStephen GregoryBenjamin C. WhitelawElisa GonzalezRajaventhan SrirajaskanthanKarger Publishersarticlecushing’s syndromeectopic varicesgastrointestinal bleedingneuroendocrine carcinomapancreatic cancerportal hypertensionDiseases of the digestive system. GastroenterologyRC799-869ENCase Reports in Gastroenterology, Vol 15, Iss 3, Pp 919-926 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cushing’s syndrome ectopic varices gastrointestinal bleeding neuroendocrine carcinoma pancreatic cancer portal hypertension Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	cushing’s syndrome ectopic varices gastrointestinal bleeding neuroendocrine carcinoma pancreatic cancer portal hypertension Diseases of the digestive system. Gastroenterology RC799-869 Scott Weerasuriya Kieran Palmer Stephen Gregory Benjamin C. Whitelaw Elisa Gonzalez Rajaventhan Srirajaskanthan Mesenteric Variceal Haemorrhage and Ectopic Cushing’s Syndrome as Presenting Features of a Pancreatic Neuroendocrine Tumour Recurrence
description	Pancreatic neuroendocrine tumours can have varied and complex presentations. Whilst hormone hypersecretion often induces characteristic clinical syndromes, non-specific symptoms may arise due to localized tumour effects. Malignant invasion of local vasculature is an increasingly recognized complication of these neoplasms and can be associated with significant morbidity. Herein, we present the case of a 47-year-old male with a recurrence of a pancreatic neuroendocrine tumour who presented with unusual upper gastrointestinal bleeding. The tumour had recurred within the superior mesenteric vein, replacing the vessel and invading its branches. This resulted in porto-mesenteric hypertension and the formation of bleeding mesenteric varices. The patient subsequently developed progressive metabolic disturbances and was diagnosed with ectopic Cushing’s syndrome, despite his primary tumour having been non-functional. This case demonstrates not only a rare pattern of tumour recurrence but also the potential for pancreatic neuroendocrine tumours to de-differentiate and change from non-functional to hormone secreting, a phenomenon which may complicate diagnosis and management.
format	article
author	Scott Weerasuriya Kieran Palmer Stephen Gregory Benjamin C. Whitelaw Elisa Gonzalez Rajaventhan Srirajaskanthan
author_facet	Scott Weerasuriya Kieran Palmer Stephen Gregory Benjamin C. Whitelaw Elisa Gonzalez Rajaventhan Srirajaskanthan
author_sort	Scott Weerasuriya
title	Mesenteric Variceal Haemorrhage and Ectopic Cushing’s Syndrome as Presenting Features of a Pancreatic Neuroendocrine Tumour Recurrence
title_short	Mesenteric Variceal Haemorrhage and Ectopic Cushing’s Syndrome as Presenting Features of a Pancreatic Neuroendocrine Tumour Recurrence
title_full	Mesenteric Variceal Haemorrhage and Ectopic Cushing’s Syndrome as Presenting Features of a Pancreatic Neuroendocrine Tumour Recurrence
title_fullStr	Mesenteric Variceal Haemorrhage and Ectopic Cushing’s Syndrome as Presenting Features of a Pancreatic Neuroendocrine Tumour Recurrence
title_full_unstemmed	Mesenteric Variceal Haemorrhage and Ectopic Cushing’s Syndrome as Presenting Features of a Pancreatic Neuroendocrine Tumour Recurrence
title_sort	mesenteric variceal haemorrhage and ectopic cushing’s syndrome as presenting features of a pancreatic neuroendocrine tumour recurrence
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/12104711115b43fd8f1b2b08de5b1d1b
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Mesenteric Variceal Haemorrhage and Ectopic Cushing’s Syndrome as Presenting Features of a Pancreatic Neuroendocrine Tumour Recurrence

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