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🌱來自: snippets

RECTALNET

Rectosigmoid neuroendocrine tumor, WHO 2017 NET G2 (Ki-67:8-18%) s/p laparoscopic low anterior resection on 2019/5/16, pT3(3cm)N0(0/19), LVI-, hepatic hemangiomas or mets?

  • check for functioning tumor or not: ask s/s such as hypoglycemia (insulinoma), diarrhea or hypokalemia (VIPoma), hot flush, diarrhea or hyperglycemia (glucagonoma), recurrent gastric ulcers (gastrinoma), or bronchoconstrition, cardiac valvular fibrosis
  • survey for MEN-1 (pituitary tumor and/or hyperparathyroidism)
  • Offer referral to NTUH 核醫科鄭湄芳 (0972653453) for gallium 68 scan clinical trial available since July, 2019 if necessary
  • Send pathology for IHC stain (SSRI 2a) @ need to arrange EGD (patient has GERD s/s) @ need to check CGA, Calcitonin, PTH-rp, GHRH, gastrin, urine 5-HIAA, serum VIP, serum glucagon, serum insulin, pro-insulin, c-peptide @ Discuss in GI/GS for hepatic hemangioma or liver mets

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