Multimodal Therapy for Pancreatic Neuroendocrine Tumors with Multiple Liver Metastases - Two Case Reports

Complete surgical resection remains the only curative treatment option for pancreatic neuroendocrine tumor (PNET). However, the proper management of PNET with liver metastasis remains debatable. We describe two patients with PNET and multiple liver metastases that were treated with aggressive surgical resection. In one case, a 45-year-old man with non-functional PNET with unresectable liver metastases received cytoreductive operation for both primary PNET and liver metastatic lesions. Thereafter, he received somatostatin analog after transcatheter arterial chemoembolization for residual liver metastases. In the other case, a 70-year-old man with functional PNET, gastrinoma, and resectable liver metastases underwent surgical resection with intent-tocure. Post-operatively, everolimus was administered as an adjuvant treatment. These patients survived after surgical management. These cases suggest that aggressive surgical management with multimodal therapy for PNET with metastases may be effective in achieving long-term survival.