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Case report
Marked improvement in hyperammonaemic encephalopathy from multimodal treatment of metastatic neuroendocrine tumour
  1. Alexander Davis1,2,
  2. Stephen Clarke2,
  3. Sally Ayesa3 and
  4. David L Chan2,3,4
  1. 1Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
  2. 2Medical Oncology, Royal North Shore Hospital, University of Sydney, Royal North Shore Hospital, New South Wales, Australia
  3. 3Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  4. 4Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia
  1. Correspondence to Dr Alexander Davis; alexanderpdavis{at}gmail.com

Abstract

Gastroenteropancreatic neuroendocrine tumours (GEPNETs) are a heterogenous group of tumours which are rising in incidence. Morbidity and mortality related to these tumours is dependent on the location of metastatic spread. Hyperammonaemia and subsequent encephalopathy has previously been described in GEPNET and is typically associated with a poor prognosis. We describe a case of a 55-year-old woman with hyperammonaemic encephalopathy and a new diagnosis of GEPNET. Given the poor prognosis and the outcomes in this patient group we feel this case highlights the benefit of a multimodality treatment approach including peptide receptor radionucleotide therapy and transarterial chemoembolisation.

  • oncology
  • hepatic cancer

https://doi.org/10.1136/bcr-2020-241191

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    Footnotes

    • Contributors SC and DLC were responsible for conception of the manuscript. DLC and AD were responsible for manuscript planning. AD was responsible for manuscript research, completion and composition. SA and DLC were responsible for composition of figures. All authors contributed to the writing of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.