Successful reversal of intestinal obstruction by PRRT: two case reports and literature review of PRRT in Small Intestinal Neuroendocrine Tumors with mesenteric fibrosis

Small intestinal neuroendocrine tumors (SI-NETs) typically follow an indolent disease course and are often accompanied by mesenteric lymph node metastases upon diagnosis. These tumors can incite a fibroblastic reaction within the mesenteric root. Here, we present two cases of patients with symptomatic small bowel obstruction due to such mesenteric involvement. These patients underwent peptide receptor radionuclide therapy (PRRT), resulting in the stabilization of the mesenteric mass and remarkable improvements in obstructive symptoms. They experienced a return to oral intake and were able to discontinue parenteral nutrition. Despite some controversies, PRRT emerges as a promising tool in managing the mesenteric mass and achieving a reversal of debilitating complications such as obstruction and mesenteric ischemia.