Conversion therapy followed by curative resection in a patient with ACTH-secreting pancreatic neuroendocrine tumor G3: a case report

The article describes a case of a 37-year-old woman with a pancreatic neuroendocrine tumor producing ACTH hormone that caused Cushing's syndrome. The tumor measured 5.7 × 2.8 cm, invaded the left adrenal gland and splenic vessels, and was accompanied by lymph node spread. The patient was classified as borderline resectable, so she received conversion therapy consisting of a long-acting somatostatin analogue followed by CapTem chemotherapy. After three months of treatment, the tumor shrank and lymph nodes markedly decreased in size. Subsequently, surgery was performed to remove part of the pancreas, spleen, left adrenal gland, and lymph nodes with complete tumor removal (R0 resection). The case demonstrates that conversion therapy can enable curative surgery even in aggressive tumors that are initially difficult to resect.