scholarly journals Searching for primaries in patients with neuroendocrine tumors (NET) of unknown primary and clinically suspected NET: Evaluation of Ga-68 DOTATOC PET/CT and In-111 DTPA octreotide SPECT/CT

2014 ◽  
Vol 48 (4) ◽  
pp. 339-347 ◽  
Author(s):  
Nils Friedemann Schreiter ◽  
Ann-Mirja Bartels ◽  
Vera Froeling ◽  
Ingo Steffen ◽  
Ulrich-Frank Pape ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Neuroendocrine Tumors ◽  
Clinical Efficacy ◽  
Unknown Primary ◽  
Primary Tumors ◽  
Pet Ct ◽  
Clinical Verification

Abstract Background. To evaluate the clinical efficacy of In-111 DTPA octreotide SPECT/CT and Ga-68 DOTATOC PET/CT for detection of primary tumors in patients with either neuroendocrine tumor of unknown primary (NETUP) or clinically suspected primary NET (SNET). Patients and methods. A total of 123 patients were included from 2006 to 2009, 52 received Ga-68 DOTATOC PET/CT (NETUP, 33; SNET, 19) and 71 underwent In-111 DTPA octreotide SPECT/CT (50; 21). The standard of reference included histopathology or clinical verification based on follow-up examinations. Results. In the NETUP group Ga-68 DOTATOC detected primaries in 15 patients (45.5%) and In-111 DTPA octreotide in 4 patients (8%) (p < 0.001); in the SNET group, only 2 primaries could be detected, all by Ga-68 DOTATOC. In patients with NETUP, primary tumors could be found significantly more often than in patients with SNET (p = 0.01). Out of these 21 patients 14 patients were operated. Conclusion. Ga-68 DOTATOC PET/CT is preferable to In-111 DTPA octreotide SPECT/CT when searching for primary NETs in patients with NETUP but should be used with caution in patients with SNET.

Solitary Cardiac Low-Grade Neuroendocrine Tumor: A Case Report and Review of the Literature

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
M Kavesh ◽  
P Drew ◽  
B Stewart
Keyword(s):  
Neuroendocrine Tumor ◽  
Frozen Section ◽  
Mitotic Rate ◽  
Complete Resection ◽  
Low Grade ◽  
Primary Tumors ◽  
Radiotracer Uptake ◽  
Pet Ct ◽  
The Right

Abstract Introduction/Objective Primary tumors of the heart are uncommon; even rarer are primary cardiac neuroendocrine tumors. To our knowledge, only two cases have been described to date, both being high-grade tumors. We report a solitary low-grade neuroendocrine tumor of the heart, unexpectedly discovered on the wall of the right ventricle in a 44-year-old man during aortic valve repair for infectious bacterial endocarditis. Results Frozen section was sent intraoperatively and showed a plasmacytoid neoplasm. Final pathology of the biopsies showed a tumor composed of both cohesive and discohesive plasmacytoid cells separated by a vascular network and strands of fibrosis. Neither necrosis nor a mitotic rate greater than 2 mitoses per 2 mm2 were seen. The tumor showed strong reactivity for AE1/3, synaptophysin and CDX2 with focal reactivity for chromogranin-A and CD56, confirming the diagnosis of a low-grade neuroendocrine tumor. Both an esophagogastroduodenoscopy and colonoscopy were performed and showed no evidence of a primary gastrointestinal tumor. PET-CT DOTATATE performed after complete resection of the tumor showed no abnormal radiotracer uptake. The possibility of an intestinal neuroendocrine tumor undetected by DOTATATE PET-CT with a single known metastasis to the heart was considered. This too, on the basis of the literature, was considered exceedingly rare. Complete resection of this patient’s tumor was considered sufficient treatment; the patient was advised to follow up annually with medical oncology. Conclusion The presentation and management of a solitary cardiac low-grade neuroendocrine tumor has not previously been described in the literature.

scholarly journals Comprehensive Treatment of Mediastinal Neuroendocrine Tumor: A Case Report

2021 ◽  
Author(s):  
Qi Yu ◽  
Zhen Li ◽  
Xinwei Han
Keyword(s):  
Case Report ◽  
Neuroendocrine Tumor ◽  
Surgical Resection ◽  
Neuroendocrine Tumors ◽  
Tumor Recurrence ◽  
Transcatheter Arterial Chemoembolization ◽  
Comprehensive Treatment ◽  
Drug Eluting ◽  
Arterial Chemoembolization

Abstract Neuroendocrine tumors in the mediastinum are relatively rare. We report a patient with mediastinal neuroendocrine tumor that was successfully resected after descending stage by drug-eluting embolic transcatheter arterial chemoembolization had been performed. No tumor recurrence was found in the 1-year follow-up after surgical resection.

scholarly journals The Impact of Repeating Endosonography with Confocal Endomicroscopy for the Diagnosis of Cystic Neuroendocrine Tumor

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Iqra Haq ◽  
Somashekar G. Krishna ◽  
Bhaveshkumar Patel ◽  
Thavam Thambi-Pillai ◽  
Chencheng Xie ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Neuroendocrine Tumors ◽  
Pancreatic Pseudocyst ◽  
Incidental Finding ◽  
Pancreatic Neuroendocrine Tumor ◽  
Needle Aspiration ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
The Impact

Cystic pancreatic neuroendocrine tumors represent around 13% of all neuroendocrine tumors (Hurtado-Pardo 2017). There has been an increase in the incidence of cases due to improvement in imaging modalities. This is a case of a 68-year-old male with the incidental finding of a pancreatic cyst on CT. Initial Endoscopic Ultrasound with Fine Needle Aspiration (EUS-FNA) showed sonographic and cytology features suggestive of a pancreatic pseudocyst. However the cyst persisted with no change in size after aspiration leading to a follow-up EUS- FNA, which was combined with needle based confocal laser endomicroscopy (nCLE). The nCLE features were consistent with a cystic pancreatic neuroendocrine tumor, which was later confirmed on histology after surgical resection.

Role of 92 gene cancer classifier assay in neuroendocrine tumor of unknown primary.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15696-e15696
Author(s):  
Aman Chauhan ◽  
Leaundra Murray ◽  
Arun Kumar Arumugam Raajasekar ◽  
Zin Myint ◽  
Lowell Brian Anthony
Keyword(s):  
Cell Carcinoma ◽  
Neuroendocrine Tumor ◽  
Merkel Cell Carcinoma ◽  
Neuroendocrine Tumors ◽  
Checkpoint Inhibitors ◽  
Primary Site ◽  
Tissue Type ◽  
Unknown Primary ◽  
Cancer Center ◽  
Merkel Cell

e15696 Background: Neuroendocrine tumor of unknown primary constitutes about 10-15 % of all neuroendocrine tumors. Identification of primary site can helps alter the management. Sunitinib is FDA approved for management of pancreatic neuroendocrine tumors, everolimus is approved for gastroenteropancreatic and bronchial NETs, immune checkpoint inhibitors are active in Merkel cell carcinoma and MIBG treatment is standard of care for pheochromocytoma. Methods: Patients with neuroendocrine tumor with unknown primary were identified from Markey Cancer Center database over a five-year period (2012-2016). Patient who underwent 92-gene reverse transcriptase polymerase chain reaction cancer classification assay (BioTheranostics Tissue Type ID) were analyzed. IRB approval was obtained. Results: 56 patients with neuroendocrine tumors with unknown primary were identified. Median age of cohort was 61 years. 28/56 patients were males. 92 gene cancer ID assay was used in 38 out of 56 patients. Primary site of tumor was identified with > 95% certainty in 36 out of 38 patients. The test reported pancreatic NET as the primary site for 10 patients, gastrointestinal NETs for 14 patients, bronchial carcinoid for 5, large call NEC for 3, Merkel cell carcinoma for two and pheochromocytoma in one patient. Conclusions: Tissue type ID was able to identify a primary site in NETs of unknown primary in majority (94.7%) of cases. The result had direct implication in management of patients with regards to FDA approved treatment options in 13/38 patients (pNETs, merkel cell and pheochromocytoma).

scholarly journals Genetic characterization of a case of sellar metastasis from bronchial carcinoid neuroendocrine tumor

2020 ◽  
Vol 11 ◽  
pp. 303
Author(s):  
. Hong Christopher S ◽  
Adam J. Kundishora ◽  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Jason M. Beckta ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Neuroendocrine Tumors ◽  
Pituitary Tumors ◽  
Metastatic Tumor ◽  
Mass Effect ◽  
Endoscopic Endonasal ◽  
Primary Tumors ◽  
Visual Deficits ◽  
History Of

Background: Metastasis to the pituitary gland from neuroendocrine tumors is a rare occurrence that may originate from primary tumors the lung, gastrointestinal tract, thyroid, and pancreas, among others. Patients may present with signs of endocrine dysfunction secondary to pituitary involvement, as well as mass effect-related symptoms including headaches and visual deficits. Despite a small but accumulating body of literature describing the clinical and histopathological correlates for pituitary metastases from neuroendocrine tumors, the genetic basis underlying this presentation remains poorly characterized. Case Description: We report the case of a 68-year-old with a history of lung carcinoid tumor who developed a suprasellar lesion, causing mild visual deficits but otherwise without clinical or biochemical endocrine abnormalities. She underwent endoscopic endonasal resection of her tumor with final pathology confirming metastasis from her original neuroendocrine tumor. Whole-exome sequencing was performed on the resected sellar tumor and matching blood, revealing increased genomic instability and key mutations in PTCH1 and BCOR that have been previously implicated in both systemic neuroendocrine and primary pituitary tumors with potentially actionable therapeutic targets. Conclusion: This is the first genomic characterization of a metastatic tumor to the sella and reports potential genetic insight, implicating PTCH1 and BCOR mutations, into the pathophysiology of sellar metastasis from primary systemic tumors.

The role of Ga-68 DOTATOC PET/CT in the detection of primary tumors in CUP-syndrome of neuroendocrine tumors (NETs)

2009 ◽  
Vol 47 (06) ◽  
Author(s):  
S Strobel ◽  
W Bohle ◽  
TM Welzel ◽  
WG Zoller ◽  
T Eichele ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Cup Syndrome ◽  
Primary Tumors ◽  
Pet Ct

scholarly journals Primary small intestinal neuroendocrine tumors are highly prevalent and often multiple before metastatic disease develops

2019 ◽  
pp. 145749691987448 ◽  
Author(s):  
J. Eriksson ◽  
O. Norlén ◽  
M. Ögren ◽  
H. Garmo ◽  
C. Ihre-Lundgren ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Neuroendocrine Tumors ◽  
Metastatic Disease ◽  
High Rate ◽  
Primary Tumors ◽  
The People ◽  
Swedish Cancer Registry ◽  
The Mean ◽  
Small Intestinal ◽  
Diagnostic Modalities

Background: Small intestinal neuroendocrine tumors are the most common of small bowel malignancies with a clinical incidence of about 1 per 100,000 persons per year. There has been a threefold increase in the incidence of small intestinal neuroendocrine tumor during later decades, but there are no studies that clarify whether this is due to a true higher incidence or if the rise is a mere product of, for instance, improved diagnostic modalities. The aim of this study was to investigate the incidence of clinical as well as subclinical small intestinal neuroendocrine tumors found at autopsy as well as describing the frequency of concomitant malignancies in patients with small intestinal neuroendocrine tumor. Materials and methods: An autopsy registry from the Malmö county population from 1970 to 1982 with an 87% autopsy rate was used. The clinical autopsy reports for patients coded for the existence of “carcinoid tumor” were scrutinized for the presence of small intestinal neuroendocrine tumor, metastatic disease, and concomitant malignancies. Details of patients with clinically diagnosed small intestinal neuroendocrine tumor during this time period were gathered from the Swedish Cancer Registry. Results: The mean annual incidence of small intestinal neuroendocrine tumor during this period was 5.33 per 100,000 individuals, and the mean annual prevalence was 581 per 100,000. The cause of death in the majority of cases was not due to small intestinal neuroendocrine tumor. In total, 48% of the people with small intestinal neuroendocrine tumor had at least one other malignancy, most commonly colorectal cancer. Conclusion: Most small intestinal neuroendocrine tumors are subclinical, and persons living with them will often die due to other causes. There was a high rate of multiple primary tumors (40%), suggesting that multiple tumors seem to arise before the advent of metastatic disease. Moreover, a comparably high rate of associated colorectal carcinoma was found.

Impact of Ga-68 DOTATATE imaging on clinical management of neuroendocrine tumor patients: Post-FDA-approval analysis of first 200 clinical patients.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 238-238
Author(s):  
Aman Chauhan ◽  
Riham Khouli ◽  
Mark Evers ◽  
Elizabeth Oates ◽  
Lowell Brian Anthony
Keyword(s):  
Decision Making ◽  
Neuroendocrine Tumor ◽  
Clinical Decision Making ◽  
Systemic Exposure ◽  
Standardized Uptake Value ◽  
Clinical Decision ◽  
Unknown Primary ◽  
Cancer Center ◽  
Ki 67 ◽  
Primary Tumors

238 Background: Gallium 68 dotatate (Ga-68 DOTA) provides physiologic imaging and assists in the localization of disease in somatostatin (SSA) receptor positive neuroendocrine tumor (NET) patients. Questions regarding the value of Ga-68 DOTA imaging in the FDA post-approval era for NET patients include: usefulness in disease monitoring, correlation of Ga-68 DOTA avidity to Ki-67 index and its impact on clinical decision making. We present our experience with 200 Ga-DOTATATE scans performed at University of Kentucky. Methods: A retrospective review of the first 200 patients who had undergone Ga-68 DOTA imaging at the Markey Cancer Center from Dec 2016 to Dec 2017 was conducted. Results: 59.5% were females and the median age was 62 (30-84 years). Primary tumor sites included: small bowel 37.5%, pancreas 18.5%, bronchial 14%, colon 3.5%, rectum 2%, appendix 1.5%, adrenal 0.5%, prostate 0.5%, others 3% and unknown primary 19%. Ga-68 DOTA scan influenced clinical decisions in 39% (n = 78) patients. Ga-68 DOTA imaging identified primary tumors in 17 of 38 patients who were classified as NET of unknown primary based on CT imaging. Subgroup analysis of mean standardized uptake value (SUV) for hepatic metastatic lesions revealed 37.3 for G1 (n = 20) as compared to 32.3 for G2 (n = 37) and 17.46 for G3 (n = 4). Mean hepatic SUV of the lesion with the greatest radiolabel uptake in 96 patients was similar irrespective of exposure to SSA LAR; 31.3 versus 27.8 for SSA versus the no SSA cohorts. Conclusions: Ga-68 DOTA imaging impacted clinical decision making in 39% of NET patients (n = 200) and identified the primary site in 17 of 38 patients with unknown primary. Systemic exposure to long acting SSA does not seem to impact quality of Ga-68 DOTA scan.

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