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									<identifier>oai:www.peertechzpublications.org:10.17352/apdt.000005</identifier>
									<datestamp>2018-09-05</datestamp>
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									<oai_dc:dc xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:mml="http://www.w3.org/1998/Math/MathML" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
										<dc:title>
										Three decades of survival in Pancreatic Neuroendocrine Tumor with Unresectable Liver Metastases
										</dc:title><dc:creator>Maddibande Ramachar Sreevathsa</dc:creator><dc:creator>Nishnata Koirala</dc:creator><dc:description>&lt;p&gt;Pancreatic neuro-endocrine tumors are rare and have a slow growth rate. They have long-term survival even when associated with hepatic metastases, after organ directed surgical treatment. Several prognostic factors have been identified for survival in pancreatic neuro-endocrine tumors with or without liver metastases. We describe a 32-year-old male patient with BMI of 16.4, presenting initially with recurrent, multiple, peptic ulcers and later carcinoid syndrome. A pancreatic neuro-endocrine tumor with synchronous bilobar liver metastases was discovered on laparotomy. The primary tumor was 7.5 centimeter in size, low-grade and well differentiated variety. Chromogranin A level was 81ng/liter (normal 39ng/liter) and Ki67 expression was 3%. The serum 5-Hydroxy indole acetic acid was 3246ng/ml(normal 0-22ng/ml), 24 hour urinary 5-hydroxy indole acetic acid was 1742 mg (normal 0-2.7mg) , serum gastrin level was 1060 pg/ml (normal &amp;lt;100pg/ml) and patient is on long-term omeprazole maintenance therapy. He has survived for 32 years without organ directed surgical treatment. Literature is briefly reviewed.&lt;/p&gt;</dc:description>
										<dc:publisher>Annals of Pancreatic Disorders and Treatment - Peertechz Publications</dc:publisher>
										<dc:date>2018-09-05</dc:date>
										<dc:type>Research Article</dc:type>
										<dc:identifier>https://doi.org/10.17352/apdt.000005</dc:identifier>
										<dc:language>en</dc:language>
										<dc:rights>Copyright © Maddibande Ramachar Sreevathsa et al.</dc:rights>
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