Pancreatic neuroendocrine neoplasm with a ring-like enhancement pattern: a case report

Backgrounds. Pancreatic neuroendocrine neoplasm (pNEN) is a highly heterogeneous entity, presenting widely varied biological behavior as well as long-term prognosis. Reliable biomarkers are urgently needed to make risk stratifications for pNEN patients, which could be beneficial to the development of individualized therapeutic strategy in the clinical practice. Here, we aimed to evaluate the predictive and prognostic roles of serum alkaline phosphatase-to-albumin ratio (APAR) in well-differentiated pNEN patients. Methods. We retrospectively analyzed the pathologically confirmed grade 1/2 pNEN patients, who were originally treated in our hospital from February 2008 to April 2018. Univariate and multivariate analyses were performed to assess the value of APAR in detecting synchronous metastases and predicting relapses following curative resections. Results. A total of 170 eligible cases were included into analysis. Logistic univariate analysis indicated APAR (P=0.002) was significantly associated with synchronous distant metastasis among well-differentiated pNEN patients, which was further demonstrated to be an independent risk factor by multivariate analysis (odds ratio 8.127, 95% confidence interval (CI) 2.105–31.372, P=0.002). For the prognostic value, APAR (P=0.007) was statistically associated with recurrence-free survival (RFS) in nonmetastatic resected pNEN patients, but it was not an independent predictor. Further subgroup analysis showed that APAR was independently related to RFS in patients with no nerve (hazard ratio (HR) 7.685, 95% CI 1.433–41.209, P=0.017) or vascular invasion (HR 4.789, 95% CI 1.241–18.473, P=0.023), respectively. Conclusion. APAR may work as a convenient pretreatment marker to detect synchronous distant metastasis for well-differentiated pNEN patients and predict recurrences for curatively resected cases without nerve or vascular invasion. However, these findings should be further verified in prospectively well-designed studies.

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Duodenal Metastasis from a Pancreatic Neuroendocrine Neoplasm

Internal Medicine ◽

10.2169/internalmedicine.5546-20 ◽

2020 ◽

Vol 59 (24) ◽

pp. 3245-3246

Author(s):

Akinobu Koiwai ◽

Morihisa Hirota ◽

Kennichi Satoh

Keyword(s):

Neuroendocrine Neoplasm ◽

Pancreatic Neuroendocrine Neoplasm ◽

Duodenal Metastasis

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Neuroendocrine Neoplasm in Cecal Appendix: A Case Report

Amadeus International Multidisciplinary Journal ◽

10.14295/aimj.v4i7.84 ◽

2019 ◽

Vol 4 (7) ◽

pp. 118-126

Author(s):

Pedro Walisson Gomes Feitosa ◽

Andrezza Lobo Rodrigues ◽

Esther Barbosa Gonçalves Felix ◽

Maria Stella Batista de Freitas Neta ◽

Sávio Samuel Feitosa Machado

Keyword(s):

Case Report ◽

Surgical Approach ◽

Iliac Fossa ◽

Neuroendocrine Neoplasm ◽

Neuroendocrine Neoplasms ◽

Histopathological Analysis ◽

High Mitotic Activity ◽

Precise Diagnosis ◽

The Right ◽

A Site

Although neuroendocrine neoplasms are relatively uncommon entities, the appendix is a site with relatively frequent emergence of this pathology and its precise diagnosis and clinical management have been a challenge for practitioners. This paper aims to present and discuss a case report of neuroendocrine neoplasia in the appendix of a patient with acute abdomen who underwent appendectomy. A 46-year-old man referred to the Emergency Department complaining of abdominal pain in the right iliac fossa and signs of peritoneal irritation. After diagnosis of acute appendicitis, the patient underwent appendectomy. In a macroscopic analysis, an area of 1.9 cm long, hardened, irregular and yellowish shapes was noted in the distal third of the appendix. Histopathological analysis showed neoplasia consisting of invasive islands of monotonous rounded epithelioid cells, large areas of necrosis, high mitotic activity, neural and angiolymphatic invasion and extension to adipose tissue compatible with invasion of the mesoappendix. Circumferential resection was compromised, suggesting the persistence of neoplasia in the patient even after the surgical approach, which would probably recommend the need for surgical approach. Therefore, the importance of sending collected materials for anatomopathological analysis is emphasized, since it helps in the clinical evaluation, in the etiological diagnosis, guides the medical conduct in the evolution of the case, as well as assisting in family mourning in cases of mortality.Keywords: Neuroendocrine tumor, Appendix, Histopathological analysis.

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