{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T21:26:12Z","timestamp":1648675572077},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund\u2002In der Schwangerschaft diagnostizierte neuroendokrine Tumoren (NET) sind eine absolute Rarit\u00e4t. Die vorliegende Kasuistik beschreibt Diagnostik und Therapie eines im 2. Trimenon symptomatisch gewordenen metastasierten NET des Pankreas.<\/jats:p><jats:p>\n          Fallbeschreibung\u2002Eine 33-j\u00e4hrige Patientin stellte sich in der 19. Schwangerschaftswoche (SSW) mit persistierender Diarrhoe in der Notaufnahme vor. Laborchemisch fiel eine ausgepr\u00e4gte Hyperkalz\u00e4mie (3,53\u200ammol\/l) auf. In der Bildgebung fand sich eine Raumforderung im Bereich des Pankreaskorpus\/-schwanzes mit ausgedehnter Lebermetastasierung. Histologisch zeigte sich ein NET (G2, SSTR-positiv) mit einer paraneoplastischen Parathormon-related-Peptide-Sekretion als Ursache der Hyperkalz\u00e4mie. Unter einer Therapie mit Octreotid normalisierte sich das Kalzium, die Diarrhoe sistierte. Nach Geburt eines gesunden Kindes (32. SSW per sectio) fand sich ein Progress; der Pankreastumor wurde komplett entfernt, die Leberfiliae so weit wie m\u00f6glich. In einem postoperativen CT zeigten sich verbliebene metastasensuspekte L\u00e4sionen, eine palliative Therapie mit Lanreotid wurde eingeleitet. Darunter ist die Patientin seit einem Jahr symptomfrei, das Serumkalzium blieb normwertig. Das Kind entwickelte sich unauff\u00e4llig.<\/jats:p><jats:p>\n          Diskussion\u2002Dieser ungew\u00f6hnliche Fall zeigt, dass es auch bei ausgedehnt metastasierten symptomatischen NETs in der Schwangerschaft weitreichende diagnostische und therapeutische Optionen geben kann, die in enger interdisziplin\u00e4rer Zusammenarbeit unter sorgf\u00e4ltiger Risiko-Nutzen-Abw\u00e4gung f\u00fcr Mutter und Kind eine Fortf\u00fchrung der Schwangerschaft erlauben.<\/jats:p>","DOI":"10.1055\/a-1340-0452","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:39:43Z","timestamp":1612831183000},"page":"143-148","source":"Crossref","is-referenced-by-count":0,"title":["Ungew\u00f6hnliche Ursache einer Hyperkalz\u00e4mie in der Schwangerschaft"],"prefix":"10.1055","volume":"59","author":[{"given":"Lisa","family":"Mehl","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin, Albertinen-Krankenhaus, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Schrader","sequence":"additional","affiliation":[{"name":"I. 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