MEHMET TOPAL PANKREAS CA TAM İYİLEŞME
Title:
Complete Metabolic Response in a Patient with Pancreatic Neuroendocrine Tumor Treated Solely with a Curcumin-Based Supplement: A Case Report

Abstract:
Pancreatic neuroendocrine tumors (PNETs) are rare malignancies with heterogeneous biological behavior. Achieving a complete metabolic response (CMR) in such tumors is uncommon, especially without standard oncologic treatment. We report the case of a 68-year-old male patient diagnosed with a pancreatic neuroendocrine tumor (ICD-10: C25) who received no chemotherapy, radiotherapy, or surgery. Instead, he was administered a curcumin-based dietary supplement called Lenesol for a duration of approximately 4.5 months. Pre-treatment PET/CT imaging on January 17, 2020 revealed multiple metastatic lesions with high DOTATATE uptake. A follow-up PET/CT on June 3, 2020 showed complete metabolic response, with no pathological uptake observed. No side effects were reported. This case demonstrates the potential role of natural curcumin formulations in modulating tumor activity in certain patients and may warrant further investigation.

Introduction:
Pancreatic neuroendocrine tumors (PNETs) represent a subset of neuroendocrine neoplasms that originate from the endocrine pancreas. While some PNETs are indolent, others can be aggressive and metastasize early. Standard treatment often includes surgical resection, somatostatin analogues, chemotherapy, or targeted therapies. However, complete metabolic response (CMR) is rarely observed, particularly without conventional treatment. In this report, we present a unique case of CMR following exclusive use of a curcumin-based nutritional supplement, Zarenca.

Case Presentation:
A 68-year-old male patient was diagnosed with a pancreatic neuroendocrine tumor in early 2020. Initial Ga-68 DOTATATE PET/CT scan on January 17, 2020 demonstrated multiple pathological uptakes in the pancreas and lymph nodes, indicating widespread metastasis. Instead of initiating any standard oncologic therapy, the patient began daily oral intake of zarenca, a proprietary curcumin-based supplement known for its anti-inflammatory and potential anti-tumor properties. No other treatment was administered. Follow-up PET/CT on June 3, 2020 showed a complete resolution of the previously observed lesions, with no abnormal DOTATATE uptake. The patient reported no side effects during or after treatment.

Discussion:
Complete metabolic response in metastatic PNETs is an uncommon outcome, especially in the absence of chemotherapy or targeted therapy. Curcumin, the active component of turmeric, has demonstrated anti-cancer effects in preclinical studies through modulation of inflammatory pathways, angiogenesis, and apoptosis. The present case suggests a potential clinical benefit of a bioavailable curcumin formulation. While anecdotal, such findings encourage further clinical trials to evaluate its efficacy and mechanism of action in neuroendocrine tumors.

Conclusion:
This case highlights a rare instance of complete metabolic remission in a metastatic PNET patient following sole administration of a curcumin-based dietary supplement. Given the absence of side effects and the impressive imaging results, further investigation into curcumin’s therapeutic potential is warranted.