Netspot neoendocrine tumor santa fe9/13/2023 SB-NETs grow slowly and tend to metastasize to the mesenteric root nodes and the liver. They are extremely rare in children and up to 30% of these tumors present in multiple sites. The annual age-adjusted incidence in the United States was 1.05 per 100,000 persons in 2012. SB-NETs occur more often during the sixth and seventh decade of life. The study shows evidence about the lack of standardized care as even the most common NET in kids, appendiceal, does not have proper guidelines for surgical treatment. For instance, in children NETs develop more frequently in the appendix, with a more indolent course, as the majority does not have metastasis. One of the largest case series of NETs in kids describes the difference between the pediatric population and adults. Data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) shows NETs constitute a relevant cancer threat despite their low incidence rate. Nonetheless, the incidence rate has increased over the last few decades given the increased detection of this pathology. There is an under diagnose of this pathology related to a low index of suspicion and relatively non-specific symptoms. NETs are uncommon in the pediatric population with an incidence around 0.995 cases per 100,000 in patients under 20 years old. The median age of diagnosis is 66 years-old and it tends to be more common in females. NETs are heterogeneous malignant neoplasms, which originate from cells with a secretory function within the neuroendocrine system. Accurate diagnostic tests will help to diagnose NETs earlier and potentially prevent carcinoid heart disease, bowel obstruction, and improve quality of life and mortality in these patients. They can be confused with an allergic reaction and the allergist should consider it as a differential diagnosis. NETs can present as carcinoid syndrome (flushing, diarrhea, abdominal pain, wheezing), which constitutes vague symptomatology and represents a challenging diagnosis for physicians. He was started on octreotide and underwent a wide hepatectomy and right hemicolectomy with improvement of symptoms. Hepatic and intestinal biopsies reported a well-differentiated NET of the ileocecal valve with hepatic metastasis. The CT scan showed thickening of the distal ileum and multiple lesions on both hepatic lobules and the colonoscopy revealed a tumor in the ileocecal valve. The 24-h urinary 5-hydroxyindoleacetic acid (5-HIAA) excretion was elevated. He denied abdominal pain, diarrhea, cough or wheezing. We present the case of a 17-year-old male with evanescent non-pruriginous erythematous lesions- flushing that appeared with food consumption, associated with conjunctival injection, warmth and diaphoresis after the lesions disappeared. We present the case of a pediatric patient initially referred under the suspicion of food allergies. CS can be confused with an allergic reaction and thus should be considered as a differential diagnosis in the allergy consult. Small bowel NETs (SB-NETs) are related to serotonin hypersecretion which causes: flushing, diarrhea, abdominal pain, bronchoconstriction and heart involvement, also known as carcinoid syndrome (CS). Neuroendocrine tumors (NETs) are heterogeneous neoplasms that originate from cells with a secretory function.
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