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PNET protocol

Irene Virgolini, Michael Gabriel, Alexander Kroiss, Elisabeth von Guggenberg, Rupert Prommegger, Boris Warwitz, Bernhard Nilica, Llanos Geraldo Roig, Margarida Rodrigues, Christian Uprimny
Physiologically increased pancreatic uptake at the head/uncinate process is observed in more than one-third of patients after injection of one of the three (68)Ga-labelled octreotide-based peptides used for somatostatin (sst) receptor (r) imaging. There are minor differences between these (68)Ga-sstr-binding peptides in the imaging setting. On (68)Ga-sstr-imaging the physiological uptake can be diffuse or focal and usually remains stable over time. Differences in the maximal standardised uptake values (SUVmax) reported for the normal pancreas as well as for pancreatic neuroendocrine tumour (PNET) lesions may be related to several factors, including (a) differences in the peptide binding affinities as well as differences in sstr subtype expression of pancreatic α- and β-cells, and heterogeneity / density of tumour cells, (b) differences in scanner resolution, image reconstruction techniques and acquisition protocols, (c) mostly retrospective study designs, (d) mixed patient populations, or (e) interference with medications such as treatment with long-acting sst analogues...
October 2016: European Journal of Nuclear Medicine and Molecular Imaging
G Zamperlini-Netto, A Zanette, E Wehbi, S Williams, R M Grant, L R Brandao
INTRODUCTION: Venous thrombotic events (VTE) are becoming more and more common in children, particularly in the hospital setting. To date, 1 in 200 children admitted to tertiary pediatric hospitals are now being recognized to develop VTE. Amongst those patients with an identified thrombotic occlusion, pediatric patients diagnosed with renal tumors have long been recognized, but their ideal management in the instances of vascular invasion remains controversial. AIM: We describe the clinical behavior of patients diagnosed with renal tumors and extra renal vascular involvement at The Hospital for Sick Children in Toronto, Canada...
April 2016: Thrombosis Research
Ester Osher, Erez Scapa, Joseph Klausner, Yona Greenman, Karen Tordjman, Alla Melhem, Ido Nachmany, Yael Sofer, Ravit Geva, Arye Blachar, Naftali Stern, Erwin Santo
OBJECTIVE: To improve the preoperative assessment of pancreatic incidentalomas (PIs) by analysis of 1 index case and characterization of the published features of intrapancreatic accessory spleen (IPAS) compared to pancreatic neuroendocrine tumor (PNET). METHODS: A search of the literature using the online database MEDLINE. RESULTS: In all, 46 cases of IPAS have been described to date: 17 were "presumed" as IPAS based on technetium-99m (Tc-99m) scanning, fine-needle aspiration (FNA) stain for CD8, or contrast-enhanced sonography; 29 were misdiagnosed as PNET and underwent surgery...
July 2016: Endocrine Practice
Duncan C Watley, Quan P Ly, Geoffrey Talmon, Chandrakanth Are, Aaron R Sasson
BACKGROUND: The natural history of nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) is largely unstudied due to its rarity. The primary goal of this study was to characterize clinical features and outcomes of incidental NF-PNETs. METHODS: An institutional review board-approved retrospective study of patients with NF-PNET evaluated by the Surgical Oncology of University of Nebraska Medical Center was performed. Patients were evaluated with dedicated pancreatic and liver imaging using multiphasic computed tomographic scan and dedicated magnetic resonance imaging protocols...
December 2015: American Journal of Surgery
Meryl Horwitz, Christelle Dufour, Pierre Leblond, Franck Bourdeaut, Cécile Faure-Conter, Anne-Isabelle Bertozzi, Marie Bernadette Delisle, Gilles Palenzuela, Anne Jouvet, Didier Scavarda, Matthieu Vinchon, Laetitia Padovani, Jean Gaudart, Dominique Figarella Branger, Nicolas Andre
PURPOSES: The purpose of this study was to retrospectively study embryonal tumors with multilayered rosettes (ETMR), a rare new entity that gathers ETAN-TR (embryonal tumor with abundant neuropil and true rosettes), ependymoblastomas, and medulloepitheliomas, in order to improve their descriptions and try to better define therapeutic modalities. METHODS: Patients with ETMR, ETAN-TR, ependymoblastoma, and medulloepithelioma treated in SFCE centres (Société Française de lutte contre les Cancers et les leucémies de l'Enfant et de l'adolescent) since 2000 were collected...
February 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Tae Wook Kang, Seong Hyun Kim, Jisun Lee, Ah Yeong Kim, Kyung Mi Jang, Dongil Choi, Min Ji Kim
PURPOSE: To compare computed tomography (CT) findings in patients with pancreatic metastasis from renal cell carcinoma (pRCC) and patients with hypervascular pancreatic neuroendocrine tumour (pNET) with a focus on the relative percentage washout (RPW). METHODS: We evaluated 16 patients with 37 pRCCs and 28 patients with 31 hypervascular pNETs using a protocol consisting of arterial and portal phase CT. Imaging findings were analyzed for comparison between the two groups...
November 2015: European Journal of Radiology
Bharat Rekhi, Girish Chinnaswamy, Tushar Vora, Sneha Shah, Venkatesh Rangarajan
Primary vulvar Ewing sarcoma (ES)/PNET is an uncommonly documented tumor, especially with molecular results. A 10-year-old girl presented with left vulvar swelling, a year ago. Her abdominopelvic ultrasound revealed a 12 cm × 8 cm sized, mixed echogenic blood-filled lesion in the left vulva; radiologically considered as a hematoma. Vulvectomy revealed a multinodular grey-brown tumor, microscopically comprising malignant round cells. Immunohistochemically, tumor cells diffusely expressed MIC2/CD99 and Fli1 and subsequently displayed EWSR1 rearrangement, confirming diagnosis of ES/PNET...
July 2015: Indian Journal of Pathology & Microbiology
Mitsuru Sugimoto, Tadayuki Takagi, Takuto Hikichi, Rei Suzuki, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Naoki Konno, Yuichi Waragai, Hiroyuki Asama, Mika Takasumi, Hiroshi Watanabe, Katsutoshi Obara, Hiromasa Ohira
AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) for grading pancreatic neuroendocrine tumors (PNETs). METHODS: A total of 22 patients were diagnosed with PNET by EUS-FNA between October 2001 and December 2013 at Fukushima Medical University Hospital. Among these cases, we targeted 10 PNET patients who were evaluated according to the World Health Organization (WHO) 2010 classification. Surgery was performed in eight patients, and chemotherapy was performed in two patients due to multiple liver metastases...
July 14, 2015: World Journal of Gastroenterology: WJG
Lisa-Marie Dilz, Timm Denecke, Ingo G Steffen, Vikas Prasad, Ludwig Fischer von Weikersthal, Ulrich-Frank Pape, Bertram Wiedenmann, Marianne Pavel
BACKGROUND: The role of systemic chemotherapy for pancreatic neuroendocrine tumours (pNET) is controversially discussed. Objective response rates (RR) reported for streptozocin (STZ)-based chemotherapy are variable and novel targeted drugs have recently been approved. However, the sequence of treatment remains unclear. We aimed to evaluate the efficacy of STZ plus 5-fluorouracil (STZ/5-FU) in a large pNET cohort. METHODS: Data from 96 pNET patients treated with STZ/5-FU were analysed retrospectively...
July 2015: European Journal of Cancer
Junya Iwama, Hideki Ogiwara, Chikako Kiyotani, Keita Terashima, Kentaro Matsuoka, Hideto Iwafuchi, Nobuhito Morota
OBJECT: Because of their large size and high vascularity, complete removal of brain tumors in infants and young children is often difficult. In most cases the degree of resection is associated with prognosis. Neoadjuvant chemotherapy may facilitate resection by reducing the vascularity of the tumor. The authors evaluated the effectiveness of neoadjuvant chemotherapy in the management of these tumors. METHODS: The authors performed a retrospective review of infants and young children who underwent tumor removal after neoadjuvant chemotherapy...
May 2015: Journal of Neurosurgery. Pediatrics
Regina I Jakacki, Peter C Burger, Mehmet Kocak, James M Boyett, Joel Goldwein, Minesh Mehta, Roger J Packer, Nancy J Tarbell, Ian F Pollack
BACKGROUND: Supratentorial PNETs (sPNET) are uncommon embryonal malignancies of the central nervous system whose prognosis has historically been poor. We evaluated the outcome and prognostic factors of children with sPNET treated prospectively on a Children's Oncology Group trial. PROCEDURE: Following surgery, patients received craniospinal radiotherapy with concurrent carboplatin followed by six months of maintenance chemotherapy with cyclophosphamide and vincristine...
May 2015: Pediatric Blood & Cancer
Manila Antonelli, Andrey Korshunov, Angela Mastronuzzi, Francesca Diomedi Camassei, Andrea Carai, Giovanna S Colafati, Stefan M Pfister, Marcel Kool, Felice Giangaspero
Embryonal tumor with abundant neuropil and true rosettes (ETANTR) is a rare subtype of primitive neuroectodermal tumors and one of the most aggressive brain tumors in children. The neoplasm harbors a specific genetic alteration, amplification of the miRNA cluster C19MC at 19q13.42. We report a case of a 21-month-old boy with a mass in the left fronto-opercular region. The lesion was partially resected and pathology examination revealed an ETANTR with immunoreativity for LIN28A protein and amplification of the C19MC locus...
May 2015: Virchows Archiv: An International Journal of Pathology
Sara Pusceddu, Filippo de Braud, Laura Concas, Cristina Bregant, Livia Leuzzi, Barbara Formisano, Roberto Buzzoni
Abnormal PI3K-AKT-mTOR pathway signalling and autocrine activation of the mTOR pathway, mediated through insulin-like growth factor-1, have been implicated in the proliferation of pancreatic neuroendocrine tumor (pNET) cells. Everolimus, an mTOR inhibitor, has shown antitumor benefit in pNETs alone and in combination with octreotide LAR in RADIANT-1 and RADIANT-3 studies. Although everolimus-based phase II/III trials have improved progression-free survival for pNET, its use has not impacted on prolonging overall survival...
November 2014: Tumori
Carsten Friedrich, Monika Warmuth-Metz, André O von Bueren, Johannes Nowak, Brigitte Bison, Katja von Hoff, Torsten Pietsch, Rolf D Kortmann, Stefan Rutkowski
OBJECT: Primitive neuroectodermal tumors of the central nervous system (CNS-PNET) arising in the brainstem are extremely rare, and knowledge about them is limited. The few existing case series report fatal outcomes. The purpose of this study was to analyze clinical characteristics of and outcome for brainstem CNS-PNET patients treated according to the consecutive, population-based HIT studies covering a 19-year time period. METHODS: Between September 1992 and November 2011, 6 eligible children with histologically proven brainstem CNS-PNET not otherwise specified and 2 children with brainstem ependymoblastomas (3, partial resection; 3, subtotal resection; 2, biopsy), median age 3...
March 2015: Journal of Neurosurgery. Pediatrics
Timothy J Hobday, Rui Qin, Diane Reidy-Lagunes, Malcolm J Moore, Jonathan Strosberg, Andreas Kaubisch, Manisha Shah, Hedy Lee Kindler, Heinz-Josef Lenz, Helen Chen, Charles Erlichman
PURPOSE: There are few effective therapies for pancreatic neuroendocrine tumors (PNETs). Recent placebo-controlled phase III trials of the mammalian target of rapamycin (mTOR) inhibitor everolimus and the vascular endothelial growth factor (VEGF)/platelet-derived growth factor receptor inhibitor sunitinib have noted improved progression-free survival (PFS). Preclinical studies have suggested enhanced antitumor effects with combined mTOR and VEGF pathway-targeted therapy. We conducted a clinical trial to evaluate combination therapy against these targets in PNETs...
May 10, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Simon Khagi, M Wasif Saif
PURPOSE OF REVIEW: Pancreatic neuroendocrine tumors (pNETs) are a rare and heterogeneous group of neoplasia. Presentation of these tumors can vary widely. Current treatment modalities range from potentially curative surgical interventions in localized disease to the use of varied hormonal analogues, cytotoxic agents and targeted therapy for the management of locally advanced and metastatic disease. With such a wide variety of therapeutic modalities, clinicians are faced with the task of building an effective and comprehensive treatment strategy for their patients...
January 2015: Current Opinion in Oncology
Scott K Sherman, Jessica E Maxwell, Jennifer C Carr, Donghong Wang, Andrew M Bellizzi, M Sue O'Dorisio, Thomas M O'Dorisio, James R Howe
Small bowel (SBNETs) and pancreatic neuroendocrine tumors (PNETs) often present with liver metastases. Although liver biopsy establishes a neuroendocrine diagnosis, the primary tumor site is frequently unknown without exploratory surgery. Gene expression differences in metastases may distinguish primary SBNETs and PNETs. This study sought to determine expression differences of four genes in neuroendocrine metastases and to create a gene expression algorithm to distinguish the primary site. Nodal and liver metastases from SBNETs and PNETs (n = 136) were collected at surgery under an Institutional Review Board-approved protocol...
December 2014: Clinical & Experimental Metastasis
U Bode, M Zimmermann, O Moser, S Rutkowski, M Warmuth-Metz, T Pietsch, R D Kortmann, A Faldum, G Fleischhack
Early studies with high-dose chemotherapy for treatment of relapsed cerebral PNET had shown modest efficacy but considerable toxicity. The HIT97 national trial tested a nonrandomized but stratified relapse protocol using either intensive chemotherapy, potentially high dose, or oral chemotherapy. 72 patients (59 disseminated) whose primary treatment had been surgery (97 %), radiotherapy (88 %), and/or chemotherapy (95 %) were enrolled in the intensive chemotherapy arm at diagnosis of relapse or resistance...
December 2014: Journal of Neuro-oncology
Surya Panicker Rajeev, Steffan McDougall, Monica Terlizzo, Daniel Palmer, Christina Daousi, Daniel J Cuthbertson
BACKGROUND: We report the case of a patient who had a non-functional metastatic pancreatic neuroendocrine tumour (pNET), which changed in functionality during the course of the disease. This case demonstrates the effectiveness of conventional cytotoxic chemotherapy in the management of select group of patients with this rare, challenging condition. CASE PRESENTATION: Our patient was a 34 year old man under oncology follow up, diagnosed with a non-functional metastatic pancreatic neuroendocrine tumour treated with a Whipple's procedure two years ago...
2014: BMC Endocrine Disorders
Pawel Buczkowicz, Ute Bartels, Eric Bouffet, Oren Becher, Cynthia Hawkins
Diffuse intrinsic pontine glioma (DIPG) is the main cause of brain tumour-related death in children. In the majority of cases diagnosis is based on clinical and MRI findings, resulting in the scarcity of pre-treatment specimens available to study. Our group has developed an autopsy-based protocol to investigate the histologic and biologic spectrum of DIPG. This has also allowed us to investigate the terminal pattern of disease and gain a better understanding of what challenges we are facing in treating DIPG...
October 2014: Acta Neuropathologica
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