scholarly journals Well-Differentiated Grade 2, Type 3 Gastrointestinal Neuroendocrine Tumour with Bilateral Metastatic Ovarian Involvement: Report of an Unusual Case

2016 ◽  
Vol 9 (1) ◽  
pp. 255-261 ◽  
Author(s):  
Ray Manneh ◽  
Daniel Castellano ◽  
Oscar Caso ◽  
Carmelo Loinaz ◽  
Jesús Jiménez ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Adjuvant Treatment ◽  
Unusual Case ◽  
Neuroendocrine Tumours ◽  
Neuroendocrine Tumour ◽  
Somatostatin Analogues ◽  
Low Grade ◽  
Well Differentiated ◽  
Type 3 ◽  
Ovarian Involvement

Treatment of metastatic gastric neuroendocrine tumours (NETs) is challenging. In oligometastatic cases, surgical resection is recommended whenever possible. Somatostatin analogues have been used to decrease gastrin levels, and available evidence suggests that these drugs can also reduce recurrences. Here we present a highly unusual case involving a patient with a well-differentiated grade 2, type 3 gastric NET with exclusive metastatic bilateral ovarian involvement. To our knowledge, this is the first such case reported in the literature, as the cause of ovarian involvement is usually due to local invasion rather than metastasis. We believe this case is of interest not only due to the unusual presentation, but also because it makes us consider adjuvant treatment with somatostatin analogues in patients with low-grade tumours and a positive postoperative octreoscan.

scholarly journals Requiem for the Term ‘Carcinoid Tumour’ in the Gastrointestinal Tract?

2008 ◽  
Vol 22 (4) ◽  
pp. 357-358 ◽  
Author(s):  
Runjan Chetty
Keyword(s):  
Gastrointestinal Tract ◽  
Neuroendocrine Carcinoma ◽  
Neuroendocrine Tumours ◽  
Neuroendocrine Tumour ◽  
Carcinoid Tumour ◽  
World Health ◽  
Low Grade ◽  
Biological Behaviour ◽  
Unique Type ◽  
Well Differentiated

Use of the term ‘carcinoid tumour’ to describe a unique type of tumour in the gastroenteropancreatic system is endemic in the medical literature and in daily clinical and pathological parlance. However, it is a somewhat misleading moniker because a spectrum of histopathological changes and hence, biological outcomes may occur in these tumours. The World Health Organization classification scheme recommends the use of the terms neuroendocrine tumours or carcinomas, which may be stratified as well-differentiated neuroendocrine tumours with benign or uncertain behaviour, well-differentiated tumours with low-grade neuroendocrine carcinoma behaviour and high-grade neuroendocrine carcinomas. These categories may be applied within different sites in the gastrointestinal tract and pancreas, and convey a sense of biological behaviour. In addition, a recently suggested tumour-node-metastasis scheme has been proposed and awaits clinical validation and acceptance. Thus, the term ‘carcinoid’ has served its purpose well, but its use should be phased out in favour of ‘neuroendocrine tumour’ or ‘neuroendocrine carcinoma’.

scholarly journals Diagnosis and Prognosis of Neuroendocrine Tumours of the Lung by Means of High Resolution Image Analysis

1999 ◽  
Vol 18 (2) ◽  
pp. 109-119 ◽  
Author(s):  
Uta Jütting ◽  
Peter Gais ◽  
Karsten Rodenacker ◽  
Joachim Böhm ◽  
Susanne Koch ◽  
...  
Keyword(s):  
Image Analysis ◽  
High Resolution ◽  
Neuroendocrine Tumours ◽  
Malignant Potential ◽  
Low Grade ◽  
Malignant Tumours ◽  
Cox Regression Analysis ◽  
Resolution Image ◽  
High Resolution Image ◽  
Well Differentiated

Neuroendocrine tumours (NET) of the lung are divided in subtypes with different malignant potential. The first is the benign or low‐grade malignant tumours, well‐differentiated, called typical carcinoids (TC) and the second is the high‐grade malignant tumours, poorly differentiated of small (SCLC) or large cell type (LCLC). Between these tumour types lies the well‐differentiated carcinoma with a lower grade of malignancy (WDNEC). In clinical routine it is very important with regard to prognosis to distinguish patients with low malignant potential from those with higher ones. In this study 32 cases of SCLC, 13 of WDNEC and 14 of TC with a follow‐up time up to 7 years were collected. Sections 4 μm thick from paraffin embedded tissue were Feulgen stained. By means of high resolution image analysis 100 nuclei per case were randomly gathered to extract morphometric, densitometric and textural quantitative features. To investigate the ploidy status of the tumour the corrected DNA distribution was calculated. Stepwise linear discriminant analysis to differentiate the classes and Cox regression analysis for the survival time analysis were applied. Using chromatin textural and morphometric features in two two‐class discriminations, 11 of the 14 TC cases and 8 of the 13 WDNEC cases were correctly classified and 11/13 WDNEC cases and 28/32 SCLC cases, respectively. The WDNEC cases are more similar in chromatin structure to TC than to SCLC. For the survival analysis, only chromatin features were selected to differentiate patients with better and worse prognosis independent of staging and tumour type.

scholarly journals A Rare Case of Mixed Neuroendocrine Tumor and Adenocarcinoma of the Pancreas

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Sofia Xenaki ◽  
Konstantinos Lasithiotakis ◽  
Alexandros Andreou ◽  
Sofia Aggelaki ◽  
Maria Tzardi ◽  
...  
Keyword(s):  
Adjuvant Treatment ◽  
Pancreatic Head ◽  
Neoplastic Disease ◽  
Low Grade ◽  
Distant Relapse ◽  
Well Differentiated ◽  
Hepatic Lesions ◽  
Adenocarcinoma Of The Pancreas ◽  
Pancreatic Head Tumor ◽  
Clinical Problems

Introduction.Neuroendocrine carcinoma (NEC) of pancreas is a rare tumor with aggressive progression and poor prognosis. Its coexistence with adenocarcinoma poses significant clinical problems and has not been addressed in the literature.Methods.We describe a case of a 51-year-old male who underwent pancreatoduodenectomy due to pancreatic head tumor1.5×1×1.4 cm. Histological examination of the specimen revealed a mixed neoplasm: (1) a well differentiated adenocarcinoma, neoplastic blasts of which are extended focally to the submucosa without invading the muscular layer, and (2) a low differentiated NEC consisting of solid clusters and pagetoid formations. All 18 lymph nodes of the specimen were free of neoplastic disease and the surgical margins of the specimen were tumor-free. No adjuvant treatment was administered and two months after the operation the patient developed liver metastasis. FNA cytology of the hepatic lesions revealed low grade carcinoma with neuroendocrine characteristics. Five lines of chemotherapy were administered: VP + CDDP, paclitaxel + ifosfamide + Mesna + CDDP, Folfox + Avastin, Folfiri + Avastin, and CAV. During his treatment he revealed PD and succumbed to his disease 13 months after the operation.Conclusion.Coexistence of NEC with adenocarcinoma of the pancreas is a very rare entity presenting significant challenges regarding its adjuvant treatment and the treatment of distant relapse.

Classification and pathology of gastroenteropancreatic neuroendocrine neoplasms

2011 ◽  
Vol 18 (S1) ◽  
pp. S1-S16 ◽  
Author(s):  
Günter Klöppel
Keyword(s):  
Gastrointestinal Tract ◽  
Neuroendocrine Tumours ◽  
Neuroendocrine Tumour ◽  
Tnm Stage ◽  
Neuroendocrine Neoplasms ◽  
Gastroenteropancreatic Neuroendocrine Neoplasms ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Neuroendocrine Carcinomas

Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are composed of cells with a neuroendocrine phenotype. The old and the new WHO classifications distinguish between well-differentiated and poorly differentiated neoplasms. All well-differentiated neoplasms, regardless of whether they behave benignly or develop metastases, will be called neuroendocrine tumours (NETs), and graded G1 (Ki67 <2%) or G2 (Ki67 2–20%). All poorly differentiated neoplasms will be termed neuroendocrine carcinomas (NECs) and graded G3 (Ki67 >20%). To stratify the GEP-NETs and GEP-NECs regarding their prognosis, they are now further classified according to TNM-stage systems that were recently proposed by the European Neuroendocrine Tumour Society (ENETS) and the AJCC/UICC. In the light of these criteria the pathology and biology of the various NETs and NECs of the gastrointestinal tract (including the oesophagus) and the pancreas are reviewed.

Intramuscular corpora amylacea adjacent to ileal low-grade neuroendocrine tumours (typical carcinoids): a light microscopic, immunohistochemical and ultrastructural study

2013 ◽  
Vol 66 (7) ◽  
pp. 569-572 ◽  
Author(s):  
Jaclyn Frances Hechtman ◽  
Ronald E Gordon ◽  
Noam Harpaz
Keyword(s):  
Neuroendocrine Tumours ◽  
Smooth Muscle Actin ◽  
Patient Characteristics ◽  
Low Grade ◽  
Tumour Mass ◽  
Corpora Amylacea ◽  
Particle Matter ◽  
Mean Diameter ◽  
Intracytoplasmic Inclusions ◽  
Well Differentiated

AimsThe purposes of this study are to (1) document the prevalence of intracytoplasmic inclusions adjacent to ileal well-differentiated neuroendocrine tumours (WNETs), (2) examine whether and how tumour and patient characteristics are associated with inclusions and (3) investigate their properties on special stains and electron microscopy in comparison with corpora amylacea (CA).MethodsWe examined the resection slides from 26 ileal, 5 gastric and 5 rectal cases of WNET. Inclusions were readily identified with H&E staining. Histochemical, immunohistochemical and ultrastructural evaluations were performed on the block with the highest number of inclusions.ResultsIntracytoplasmic inclusions occurred adjacent (<1 mm) to 15 of 26 (57.7%) ileal WNETs. Patients with and without inclusions were of similar mean ages (59.5 vs 57.4 years; p=0.88), but NETs with inclusions were larger than those without inclusions (3.3 vs 1.7 cm, p=0.03). Inclusions were neither associated with gastric (mean age=65 years, mean diameter=1.5 cm) or rectal WNETs (mean age=47.8 years, mean diameter=0.5 cm) (p=0.01), nor were they present >1 mm from ileal NETs. CA stained strongly for ubiquitin, DPAS and Alcian blue; faintly and peripherally for desmin and smooth muscle actin and negatively for calcium. Ultrastructurally, their appearance was consistent with filaments, some with cores of particle matter.ConclusionsOur results suggest that these inclusions are virtually identical to CA and present adjacent to the majority of ileal WNET. They may be the result of a degenerative process, possibly due to chronic myocyte stress from an infiltrating slow growing tumour mass or local hormonal effects.

scholarly journals An unusual case of a well-differentiated neuroendocrine tumour of the ileum with peritoneal carcinomatosis: a case report

2015 ◽  
Vol 13 (1) ◽  
Author(s):  
Andrea Celotti ◽  
Giuseppe Pulcini ◽  
Mattia Schieppati ◽  
Silvia Ministrini ◽  
Alfredo Berruti ◽  
...  
Keyword(s):  
Case Report ◽  
Peritoneal Carcinomatosis ◽  
Unusual Case ◽  
Neuroendocrine Tumour ◽  
Well Differentiated

scholarly journals Exploring the current status of neuroendocrine tumours: a population-based analysis of epidemiology, management and use of resources

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Josep Darbà ◽  
Alicia Marsà
Keyword(s):  
Disease Management ◽  
Neuroendocrine Tumours ◽  
Neuroendocrine Tumour ◽  
Fold Increase ◽  
Current Status ◽  
Metastatic Tumour ◽  
Neuroendocrine Neoplasms ◽  
Use Of Resources ◽  
Poorly Differentiated Neuroendocrine Carcinoma ◽  
Well Differentiated

Abstract Background Neuroendocrine tumours (NETs) are rare malignancies characterised by its capacity to synthesise and secrete monoamines, due to its neuroendocrine origin. Its varied locations and symptoms have traditionally been responsible for extended delays in their diagnosis. The interest of this study was to characterise the patient population diagnosed with NETs in Spain and to revise how the disease is managed, together with the hospitalisation costs of these patients. Methods The database included records of all patients diagnosed with a NET between 2010 and 2015. Admission records were used to evaluate hospitalisation, disease management data and costs, and single-patient files were used to characterise the population. Results Nine Thousand One Hundred Twenty patients were diagnosed with a neuroendocrine tumour between 2010 and 2015, with a 2 fold increase in the diagnosis rate over the study period. 42.25% of the patients were females, while 57.75% were males, and mean diagnosis age was 62.58 years (SD = 14.65). Considering all the registered neuroendocrine neoplasms, 46.86% of the patients had malignant well-differentiated NETs, 32.02% had a malignant poorly differentiated neuroendocrine carcinoma and 42.93% of patients developed metastatic NETs. In addition, 18.59% of patients were diagnosed with benign well-differentiated NETs. The most common tumour sites were the bronchus, lung and other sites, including pancreatic tumours; metastasis was found in the liver and distant lymph nodes. Pancreatic resection was the most common surgical procedure utilised in these patients, summing 19% of total expenses, the injection of an unspecified therapeutic substance (including targeted therapies) was registered in 11.40% of admissions, while chemotherapy was registered in only 6.85% of admissions. The annual healthcare cost of NETs was €15,373,961, corresponding to €9092 per patient. Conclusions The implementation of standard diagnosis procedures should be prioritised, with a focus on the pancreas and lung, and taking into account that 42.93% of the patients develop a metastatic tumour. The presence of comorbidities and multimorbidities should be considered in order to develop more efficient disease management protocols.

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