CASE REPORT article

Front. Oncol.

Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1590478

Case Report: PRRT in a patient with Zollinger-Ellison Syndrome. The management of gastrointestinal complications

Provisionally accepted
Martina Di FrancoMartina Di Franco1Rexhep DurmoRexhep Durmo2*Maria Liberata Di PaoloMaria Liberata Di Paolo2Roberto GiacosaRoberto Giacosa3Elisa BannòElisa Bannò4Valentina AmbrosiniValentina Ambrosini1,5Angelina FiliceAngelina Filice2
  • 1Alma Mater Studiorum, University of Bologna, Bologna, Emilia-Romagna, Italy
  • 2Department of Nuclear Medicine, S. Maria Nuova Hospital, IRCCS Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
  • 3Gastroenterology and Digestive Endoscopy Unit, S. Maria Nuova Hospital, IRCCS Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
  • 4Oncology Medicine Unit, Area Nord-Mirandola, AUSL Modena, Modena, Italy
  • 5Nuclear Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

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Peptide Receptor Radionuclide Therapy (PRRT) with [177Lu]Lutetium Oxodotreotide is an effective treatment for advanced neuroendocrine tumors, including those associated with Zollinger Ellison Syndrome (ZES). However, the gastrointestinal toxicity induced by ZES can complicate the administration of PRRT. We present a case of a patient with metastatic G2 neuroendocrine tumor of the duodenum who experienced severe gastrointestinal complications after the first PRRT cycle due to exacerbated ZES. The implementation of a prophylactic treatment with high-dose proton pump inhibitors before and after the subsequent PRRT cycles allowed for the successful completion of the therapy. This case highlights the importance of considering ZES-related complications in patients undergoing PRRT.

Keywords: Gastrointestinal Cancers: Gastric and Esophageal Cancers Angelina Filice: Supervision, Writingoriginal draft, Writingreview & editing. Elisa Bannò: Writingreview & editing. Maria Liberata Di Paolo: Writingoriginal draft, Writingreview & editing. Martina Di Franco: Writingoriginal draft, Writingreview & editing. Rexhep Durmo: Conceptualization, Writingreview & editing. Roberto Giacosa: Writingreview & editing. Valentina Ambrosini: Supervision, Writingreview & editing PRRT, NET

Received: 09 Mar 2025; Accepted: 28 Apr 2025.

Copyright: © 2025 Di Franco, Durmo, Di Paolo, Giacosa, Bannò, Ambrosini and Filice. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Rexhep Durmo, Department of Nuclear Medicine, S. Maria Nuova Hospital, IRCCS Local Health Authority of Reggio Emilia, Reggio Emilia, 42020, Italy

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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