Uncommon sites for metastasis of neuroendocrine tumor in adults

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15683-e15683
Author(s):  
R. Srirajaskanthan ◽  
K. Desai ◽  
A. Jayaratnam ◽  
E. Carras ◽  
C. Toumpanakis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pet Imaging ◽  
Neuroendocrine Tumour ◽  
Imaging Modality ◽  
Primary Tumour ◽  
Somatostatin Receptor ◽  
Histological Evaluation ◽  
Ocular Involvement ◽  
Metastatic Focus ◽  
Cross Sectional

e15683 Background: Neuroendocrine tumours are relatively slow growing tumours. They often present with significant metastatic disease affecting liver, lymph nodes, lungs and bone. However tumour masses may be found at unusual/uncommon sites e.g. breast, orbital soft tissue and the heart raising the possibility of this being metastatic focus or presence of another primary tumour. Detection of these sites could have a significant impact on the available treatment options. Aim: to determine the most appropriate imaging modality and type of tumour metastases. Methods: We reviewed 300 consecutive clinic patients. We identified 18 patients with metastasis at uncommon sites i.e. breast, orbital and cardiac. We retrospectively evaluated clinical notes and recent radiological investigations of these patients. To characterise these lesions additional investigations included cross sectional imaging, PET imaging (68Gallium DOTA Octreotate PET and 18F- FDG PET) and histological evaluation of the metastasis where appropriate. Patients with breast metastasis underwent bilateral mammogram, patients with peri-ocular involvement underwent MRI of the brain and the orbit. Results: 18 patients had tumour masses at uncommon sites. Of these 15 masses were in the breast; 4 were in the orbital muscles and 2 patients had pericardial metastasis. Of the 15 patients with breast lesions 12 had confirmed neuroendocrine tumour metastases and 3 had breast cancer. It should be noted that breast cancer lesions were positive on the 68Gallium Octreotate PET imaging. One patient who had a defined metastasis in the pericardium showed avid uptake on the 68Gallium DOTA Octreotate PET and scan and cardiac MRI, the other patient had pericardial metastases confirmed at post mortem. Conclusions: Clear knowledge of these uncommon sites of metastasis is useful in terms of arranging further investigations and excluding other cancers. It is also important to realise that although somatostatin receptor scintigraphy especially 68Gallium DOTA Octreotate PET is very useful in detecting NET metastasis, it may also show avid uptake in patients with breast cancer and hence histological evaluation of these lesions are important. Undoubtedly within our cohort of patients and generally there is an under-diagnosis of lesions in uncommon sites. No significant financial relationships to disclose.

scholarly journals GHRH secretion from a pancreatic neuroendocrine tumor causing gigantism in a patient with MEN1

2021 ◽  
Vol 2021 ◽  
Author(s):  
Vinaya Srirangam Nadhamuni ◽  
Donato Iacovazzo ◽  
Jane Evanson ◽  
Anju Sahdev ◽  
Jacqueline Trouillas ◽  
...  
Keyword(s):  
Neuroendocrine Tumour ◽  
Primary Tumour ◽  
Elevated Serum ◽  
Pancreatic Neuroendocrine Tumor ◽  
Pituitary Surgery ◽  
List Type ◽  
Ki 67 ◽  
Subtotal Parathyroidectomy ◽  
Cross Sectional ◽  
Ectopic Acromegaly

Summary A male patient with a germline mutation in MEN1 presented at the age of 18 with classical features of gigantism. Previously, he had undergone resection of an insulin-secreting pancreatic neuroendocrine tumour (pNET) at the age of 10 years and had subtotal parathyroidectomy due to primary hyperparathyroidism at the age of 15 years. He was found to have significantly elevated serum IGF-1, GH, GHRH and calcitonin levels. Pituitary MRI showed an overall bulky gland with a 3 mm hypoechoic area. Abdominal MRI showed a 27 mm mass in the head of the pancreas and a 6 mm lesion in the tail. Lanreotide-Autogel 120 mg/month reduced GHRH by 45% and IGF-1 by 20%. Following pancreaticoduodenectomy, four NETs were identified with positive GHRH and calcitonin staining and Ki-67 index of 2% in the largest lesion. The pancreas tail lesion was not removed. Post-operatively, GHRH and calcitonin levels were undetectable, IGF-1 levels normalised and GH suppressed normally on glucose challenge. Post-operative fasting glucose and HbA1c levels have remained normal at the last check-up. While adolescent-onset cases of GHRH-secreting pNETs have been described, to the best of our knowledge, this is the first reported case of ectopic GHRH in a paediatric setting leading to gigantism in a patient with MEN1. Our case highlights the importance of distinguishing between pituitary and ectopic causes of gigantism, especially in the setting of MEN1, where paediatric somatotroph adenomas causing gigantism are extremely rare. Learning points It is important to diagnose gigantism and its underlying cause (pituitary vs ectopic) early in order to prevent further growth and avoid unnecessary pituitary surgery. The most common primary tumour sites in ectopic acromegaly include the lung (53%) and the pancreas (34%) (1): 76% of patients with a pNET secreting GHRH showed a MEN1 mutation (1). Plasma GHRH testing is readily available in international laboratories and can be a useful diagnostic tool in distinguishing between pituitary acromegaly mediated by GH and ectopic acromegaly mediated by GHRH. Positive GHRH immunostaining in the NET tissue confirms the diagnosis. Distinguishing between pituitary (somatotroph) hyperplasia secondary to ectopic GHRH and pituitary adenoma is difficult and requires specialist neuroradiology input and consideration, especially in the MEN1 setting. It is important to note that the vast majority of GHRH-secreting tumours (lung, pancreas, phaeochromocytoma) are expected to be visible on cross-sectional imaging (median diameter 55 mm) (1). Therefore, we suggest that a chest X-ray and an abdominal ultrasound checking the adrenal glands and the pancreas should be included in the routine work-up of newly diagnosed acromegaly patients.

Outcome of mammography examination among asymptomatic women.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13558-e13558
Author(s):  
Hadijat Oluseyi Kolade-Yunusa
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Early Stage ◽  
Imaging Modality ◽  
Positive Outcome ◽  
Radiology Department ◽  
Architectural Distortion ◽  
Cross Sectional ◽  
Mammographic Examination ◽  
Asymptomatic Women

e13558 Background: Early detection of breast cancer is important in reducing mortality, morbidity and high socio-economic burden associated with it. Mammography is currently the primary imaging modality used as a screening tool to detect early breast cancer in women experiencing no symptoms as they are most curable in the early stage. The aim of the study is to determine the mammographic outcome in asymptomatic women who presented for mammographic breast examination in Abuja,Nigeria. Methods: This descriptive cross-sectional study comprises of 113 asymptomatic women who presented for mammographic examination at the Radiology department of University of Abuja Teaching Hospital, Gwagwalada from March 2015 to December 2018. Two basic views (craniocaudal and mediolateral views) of the breast were obtained using EXR-650 machine.Additional views were obtained when necessary. Images of the breast were review by radiologist. Results: The mean age of study population was 40.72 ±10.45years with age range of 35 and 65 years. The mammographic outcome among asymptomatic women who had mammographic examination was negative in 69(61.1%) women and positive in 44(38.9%). The differences observed between the positive and negative mammographic outcome was statistically significant p = 0.01. The positive outcome noted in mammograms of women examined were: benign mass in 18(15.9%) women; 9(8.0%) had benign calcification; 7(6.2%) showed architectural distortion; 5(4.4%) was inconclusive; focal asymmetry in 3(2.6%); and suspicious mass in 2(1.8%). Conclusions: Mammogram is an important tool for screening and diagnoses of breast pathologies. In this study, screening of women reveals various benign and malignant breast changes which necessitate early interventions. Early detection of breast cancer save lives. [Table: see text]

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

The truncated somatostatin receptor sst5TMD4 stimulates the production of pro-angiogenic factors in in vitro and in vivo breast cancer models

2014 ◽  
Author(s):  
Raul M Luque ◽  
Mario Duran-Prado ◽  
David Rincon-Fernandez ◽  
Marta Hergueta-Redondo ◽  
Michael D Culler ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Somatostatin Receptor ◽  
Angiogenic Factors ◽  
Cancer Models

THE RELATION OF COPPING STRATEGY BY LOOKING SOCIAL SUPPORT WITH STRESS LEVEL OF BREAST CANCER PATIENT WHO GONE TROUGH CHEMOTHERAPY

2018 ◽  
Vol 1 (1) ◽  
pp. 51-54
Author(s):  
Sri Burhani Putri
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Cancer Patient ◽  
Breast Cancer Patient ◽  
Cross Sectional Study ◽  
P Value ◽  
Spiritual Support ◽  
Cross Sectional ◽  
Breast Cancer Chemotherapy ◽  
Patient Stress

Breast cancer is one of the most common illness that killed woman. One of the therapy to cure breast cancer is chemotherapy. Chemotherapy has side effect either physical and psychology, that caused people who’s in chemo therapy, prone to stress. Stress effected by many factors, such as characteristic and chopping strategy that patient has been using. The aim of this research is to get a perspective about the relation of characteristic and chopping strategy with breast cancer patient stress, whose in chemo therapy. This research using cross sectional study and taking sample by using accidental sampling method. The data analyzed by using bavariat and multivariat with variable result shows that breast cancer patient stress who has chemo therapy realted to age characteristic (p value = 0.00) the time since they diagnosed with cancer (pvalue = 0.03), how long they have chemo therapy (pvalue = 0.00) and chopping strategyby looking social support (pvalue = 0.00) looking for spiritual (pvalue = 0.00) with dominan variable which related to stress is chopping strategy to looking spiritual support (coeffecients B = -1.139).   Key words : Breast cancer, chemotherapy, stress  

HUBUNGAN ANTARA UMUR DAN STATUS PERKAWINAN DENGAN KEJADIAN KANKER PAYUDARA DI INSTALASI BEDAH RUMAH SAKIT UMUM PUSAT DR. MOHAMMAD HOESIN PALEMBANG TAHUN 2012

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Rini Mayasari Rini Mayasari
Keyword(s):  
Breast Cancer ◽  
Marital Status ◽  
Cancer Incidence ◽  
Random Sampling ◽  
Breast Cancer Incidence ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Systematic Random Sampling ◽  
Breast Cancer Event

ABSTRACT Breast cancer on the mark with the growth or uncontrolled growth of cells that are excessive. Factors affecting the incidence of breast cancer include maternal age, marital status, family history, hormone use, radiation, manarche, and obesity. The purpose of this study was to determine the relationship between Age and Marital Status of Mother with Breast Cancer incidence in the Installation Surgeon General Hospital Dr. Mohammad Hoesin Palembang in 2012. The study design was analytical descriptive with the approach in which the independent variables Cross Sectional Age Mother and Status Perkawianan and dependent variables in breast cancer incidence collected at the same time. The study population was all women who develop breast cancer in the Installation General Hospital Surgery Center Dr. Mohammad Hoesin Palembang in 2012 and samples taken by systematic random sampling with a sample of 130 respondents. The results of univariate analysis of data showed that respondents had breast cancer with a percentage of total 58 (44.61%) while respondents who had not had breast cancer totaled 72 by the percentage (63.39%). Respondents by Age Mothers who are at risk amounted to 34 by the percentage (26.15%) while respondents with Age Mothers who are not at risk amounted to 96 by the percentage (73.85%). Respondents by Marital Status is married and the mother who totaled 69 by the percentage (53.07%) and Marital Status with the status of unmarried women totaled 61 by the percentage (46.03%). Of Chi-Square test results found no significant relationship between Age Mothers with Breast Cancer event in which the p value = 0.007, no significant relationship between Marital Status in Breast Cancer event in which the p value = 0.030. Based on the results of the study, researchers suggest counseling efforts, medical knowledge and improve the quality of health services in order to reduce the incidence of breast cancer..   ABSTRAK Kanker payudara di tandai dengan pertumbuhan atau perkembangan tidak terkontrol dari sel-sel yang berlebihan. Faktor-faktor yang mempengaruhi kejadian kanker payudara antara lain umur ibu, status perkawinan, riwayat keluarga, penggunaan hormon, radiasi, manarche, dan obesitas. Tujuan penelitian ini adalah untuk mengetahui hubungan antara Umur Ibu dan Status Perkawinan dengan kejadian Kanker Payudara di Instalasi Bedah Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Tahun 2012. Desain Penelitian ini adalah deskriptif analitik dengan pendekatan Cross Sectional dimana variabel independen Umur Ibu dan Status Perkawianan dan variabel dependen kejadian kanker payudara dikumpulkan dalam waktu yang bersamaan. Populasi penelitian ini adalah semua ibu yang menderita kanker payudara di Instalasi Bedah Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Tahun 2012 dan sampel di ambil secara systematic random sampling dengan jumlah sampel 130 responden. Hasil analisis univariat data menunjukan responden yang mengalami Kanker Payudara berjumlah 58 dengan persentase sebesar (44,61%) sedangkan responden yang tidak mengalami Kanker Payudara berjumlah 72 dengan persentase (63,39%). Responden dengan Umur Ibu yang beresiko berjumlah 34 dengan persentase (26,15%) sedangkan responden dengan Umur Ibu yang tidak beresiko berjumlah 96 dengan persentase (73,85%). Responden dengan Status Perkawinan ibu yang berstatus kawin berjumlah 69 dengan persentase (53,07%) dan Status Perkawinan ibu yang berstatus tidak kawin berjumlah 61 dengan persentase (46,03%). Dari hasil uji Chi-Square didapatkan ada hubungan bermakna antara Umur Ibu dengan kejadian Kanker Payudara dimana p Value = 0,007, ada hubungan bermakna antara Status Perkawinan dengan kejadian Kanker Payudara dimana p Value = 0,030. Berdasarkan hasil penelitian, peneliti menyarankan upaya-upaya penyuluhan, pengetahuan tenaga medis dan meningkatkan mutu pelayanan kesehatan guna menurunkan angka kejadian kanker payudara.

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