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Pancreatic neuroendocrine tumour

E Bertani, N Fazio, D Radice, C Zardini, G Spinoglio, A Chiappa, D Ribero, R Biffi, S Partelli, M Falconi
BACKGROUND: The role of primary tumour surgery in pancreatic neuroendocrine tumours (PNETs) with unresectable liver metastases is controversial and international guidelines do not recommend surgery in such cases. Resectability of the primary tumour has never been considered in outcome comparisons between operated and non-operated patients. METHODS: From two institutional prospective databases of patients affected by PNET and unresectable liver metastases, 63 patients who underwent a left-pancreatectomy at diagnosis were identified and compared with a group of 30 patients with a potentially resectable but not-resected primary tumour located in the body or tail...
September 30, 2016: European Journal of Surgical Oncology
Malcolm Boyce, Katie A Lloyd, D Mark Pritchard
Gastrin controls gastric acid secretion and mucosal cell growth, especially of enterochromaffin-like cells, via gastrin/cholecystokinin-2 receptor (CCK2R) binding and downstream signalling. Studies in animal models, healthy subjects and patients with gastric neuroendocrine tumours provide compelling evidence to justify developing a CCK2R antagonist (CCK2RA) for preventing or treating the trophic effects of hypergastrinaemia or conditions expressing CCK2R, and with or without a proton pump inhibitor, for treating gastric acid-related conditions...
October 3, 2016: Current Opinion in Pharmacology
S Partelli, R Cirocchi, S Crippa, L Cardinali, V Fendrich, D K Bartsch, M Falconi
BACKGROUND: The incidence of asymptomatic, sporadic, small non-functioning pancreatic neuroendocrine neoplasms (NF-PNENs) has increased in recent decades. Conservative treatment has been advocated for these tumours. The aim of this study was systematically to evaluate the literature on active surveillance and to compare this with surgical management for asymptomatic sporadic small NF-PNENs. METHODS: PubMed, Embase and the Cochrane Library were searched systematically for studies that compared the active surveillance of asymptomatic, sporadic, small NF-PNENs with surgical management...
October 5, 2016: British Journal of Surgery
Zdeněk Fryšák, David Karásek
UNLABELLED: Decrease of blood glucose levels below 3 mmol/l is in fully developed cases accompanied by neuroglycopenic symptoms that may even lead to altered state of consciousness. The treating physician frequently faces a complicated situation. This may be due to inappropriately administered drugs including cases motivated by self-harm intentions (insulin, insulin secretagogues), or alcohol abuse. Undernourished people, or those afflicted with a serious systemic infection, end-stage liver or kidney diseases or with a failing heart, belong to a risk group...
2016: Vnitr̆ní Lékar̆ství
Chiara Caporali, Francesco Albanese, Diana Binanti, Francesca Abramo
BACKGROUND: Feline paraneoplastic alopecia (FPA) is a rare condition listed among the cutaneous paraneoplastic syndromes, which occurs in association with pancreatic carcinoma, cholangiocarcinoma, hepatocellular carcinoma and metastatic intestinal carcinoma. OBJECTIVES: To describe the clinicopathological findings of paraneoplastic alopecia in two cats each with an uncommon tumour not previously reported in association with FPA. ANIMALS: Paraneoplastic alopecia was associated with neuroendocrine pancreatic neoplasia in a Persian cat and with a hepatosplenic plasma cell tumour in a domestic short hair cat...
September 7, 2016: Veterinary Dermatology
D Maccora, G V Walls, G P Sadler, R Mihai
INTRODUCTION The 2012 British Association of Endocrine and Thyroid Surgeons audit report showed that only 86 of 1359 patients who underwent adrenalectomy had a bilateral operation; thus the experience with this procedure remains limited. METHODS Retrospective review of patients undergoing bilateral adrenalectomy in a tertiary referral centre. RESULTS Between November 2005 and January 2016, bilateral adrenalectomy was performed in 23 patients (6 male, 17 female, age 43 ± 4 years) diagnosed with Cushing's disease (n = 13), hereditary phaeochromocytomas (n = 6), adrenocortical cancer (n = 2), colorectal metastatic disease (n = 1) and adrenocortical adenomas (n = 1)...
August 23, 2016: Annals of the Royal College of Surgeons of England
Emad Lotfalizadeh, Maxime Ronot, Mathilde Wagner, Jérôme Cros, Anne Couvelard, Marie-Pierre Vullierme, Wassim Allaham, Olivia Hentic, Philippe Ruzniewski, Valérie Vilgrain
OBJECTIVES: To evaluate the value of MR imaging including diffusion-weighted imaging (DWI) for the grading of pancreatic neuroendocrine tumours (pNET). MATERIAL AND METHODS: Between 2006 and 2014, all resected pNETs with preoperative MR imaging including DWI were included. Tumour grading was based on the 2010 WHO classification. MR imaging features included size, T1-w, and T2-w signal intensity, enhancement pattern, apparent (ADC) and true diffusion (D) coefficients...
August 19, 2016: European Radiology
Myriam Wartski
The existing recommendations for fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) use in digestive cancers (excluding neuroendocrine tumours) are summarized in the present article. FDG-PET/CT is nowadays a routine imaging modality for digestive malignancies and its use is currently increasing. FDG-PET/CT is considered to be a crucial tool in pretherapeutic assessment of esophageal, localized pancreatic and anal cancer. It represents a key exam in suspicion of recurrence of colorectal cancer in case of elevated serum tumor markers...
September 2016: La Presse Médicale
Abid Ali Mirza, Esha Pai, Kodaganur Gopinath Srinivas, Shankarappa Amarendra, K S Gopinath
With the increasing use of 18F-Fluro-Deoxyglucose (FDG) Positron Emission Tomography (PET) the number of thyroid incidentalomas is on the rise. Focal thyroid incidentalomas identified by FDG-PET have been reported to have a high incidence of malignancy. Neuroendocrine tumours of the thyroid are rare entities. The most common neuroendocrine tumour of the thyroid is medullary carcinoma. A thyroid nodule in a patient with a known neuroendocrine tumour must be differentiated from a primary medullary carcinoma which can present as a diagnostic challenge to the clinician...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Nicholas A R Clarke, Harsh A Kanhere, Markus I Trochsler, Guy J Maddern
OBJECTIVE: Liver resections for non-colorectal non-neuroendocrine liver metastases (NCNELM) are gaining popularity. This study examines the outcomes of liver resections in patients with NCNELM in an Australian hospital. METHOD: A database search identified 21 attempted liver resections on 20 patients (12 men, eight women, mean age: 63.1) from 1998 to 2013. A retrospective analysis considered patient demographics and primary malignancy details. Complication rates were compared to those for colorectal metastases at the same institution...
August 3, 2016: ANZ Journal of Surgery
Francisco Sánchez-Bueno, José Manuel Rodríguez González, Gloria Torres Salmerón, Antonio Bernabé Peñalver, María Balsalobre Salmeron, Jesús de la Peña Moral, Matilde Fuster Quiñonero, Pascual Parrilla Paricio
INTRODUCTION: The aim of this study was to analyze prognostic factors for survival and recurrence in patients with resected pancreatic neuroendocrine tumors (PNT). METHODS: Medical records of 95 patients with resected PNT were retrospectively reviewed. The variables studied were: age, sex, form of presentation (sporadic/familial tumors), functionality, type of tumor, localization, type of surgery, tumor size, multifocal tumors and recurrent rate. The new WHO classification (2010) was used...
October 2016: Cirugía Española
Giandomenico Roviello, Laura Zanotti, Sergio Venturini, Alberto Bottini, Daniele Generali
BACKGROUND: Several randomized phase III trials in neuroendocrine tumors (NETs) showed the clinical role of new targeted agents and their impact on tumor response and outcome of whose patients affected by advanced NET. In this study, we summarize the available clinical data related to clinical efficacy of targeted therapies in the treatment of advanced NETs. METHODS: A meta-analysis of randomized studies in accordance with the PRISMA guidelines was performed after searching the databases of PubMed, the Cochrane Library, and the ASCO University Meeting for relevant publications...
September 2016: Cancer Biology & Therapy
Alexa Childs, Amy Kirkwood, Julien Edeline, Tu Vinh Luong, Jennifer Watkins, Angela Lamarca, Doraid Alrifai, Phyllis Nsiah-Sarbeng, Roopinder Gillmore, Astrid Mayer, Christina Thirlwell, Debashis Sarker, Juan W Valle, Tim Meyer
Chemotherapy (CT) is widely used for neuroendocrine tumours (NETs), but there are no validated biomarkers to predict response. The Ki-67 proliferation index has been proposed as a means of selecting patients for CT, but robust data are lacking. The aim of this study was to investigate the relationship between response to chemotherapy and Ki-67 in NET. We reviewed data from 222 NET patients treated with CT. Tumours were graded according to Ki-67 index: G1 ≤2%, G2 3-20% and G3 >20%. Response was assessed according to RECIST and survival calculated from start of chemotherapy to death...
July 2016: Endocrine-related Cancer
M Yang, B-L Tian, Y Zhang, A-P Su, W-G Wang, P-J Yue
Cushing's syndrome caused by an ectopic tumour secreting adrenocorticotropic hormone (ACTH) is not common. Furthermore, an ACTH-secreting panreatic neoplasm is extremely rare. We present a 27-year old female patient suffering from a pancreatic neuroendocrine tumour (p-NET) with extensive pelvic metastases, which could secret ACTH and cause Cushing's syndrome. The postoperative pathologic examinations of this patient prompted pancreatic poorly differentiated neuroendocrine tumour with extensive metastases of bilateral ovarian, uterus and pelvic peritoneum...
May 15, 2016: West Indian Medical Journal
Vikas Prasad, Nikolaus Tiling, Timm Denecke, Winfried Brenner, Ursula Plöckinger
PURPOSE: Neuroendocrine tumours of the pancreas (pNET) are observed in 8 - 17 % of patients with von Hippel-Lindau disease (vHLD), and 11 - 20 % of these patients develop metastatic disease. MRI and CT have a very high resolution; however, their sensitivity and specificity for the detection of pNET amongst cystic lesions in the pancreas of vHLD patients are generally considered insufficient. In contrast, (68)Ga-DOTATOC PET/CT demonstrates a high sensitivity for the diagnosis and staging of neuroendocrine tumours...
October 2016: European Journal of Nuclear Medicine and Molecular Imaging
Mark J Anderson, Christina A Kwong, Mohammed Atieh, Sam G Pappas
Most pancreatic cancers arise from a single cell type, although mixed pancreatic carcinomas represent a rare exception. The rarity of these aggressive malignancies and the limitations of fine-needle aspiration (FNA) pose significant barriers to diagnosis and appropriate management. We report a case of a 54-year-old man presenting with abdominal pain, jaundice and a hypodense lesion within the uncinate process on CT. FNA suggested poorly differentiated adenocarcinoma, which was subsequently resected via pancreaticoduodenectomy...
2016: BMJ Case Reports
Amandine Berdelou, Valérie Boige, Julia Arfi-Rouche, David Malka, Stéphane Ederhy, Hassan Izzedine, Sophie Leboulleux, Cécile N Chougnet, Pascal Burtin, Thierry De Baere, Agnès Laplanche, Dominique Elias, Martin Schlumberger, Jean-Yves Scoazec, Michel Ducreux, Eric Baudin
BACKGROUND: At least 9 therapeutic options are recommended or approved for pancreatic neuroendocrine tumour (pNET). The primary endpoint of this study was to determine the number of therapeutic lines given before death. Secondary endpoints were to determine toxic events as a function of number of therapeutic lines and of time. METHODS: Patients with pNET treated between 1998 and 2010 at our Centre were characterized. All therapeutic lines were recorded as well as tumour- or, toxic-related deaths...
May 26, 2016: Neuroendocrinology
Y Nakamoto, T Ishimori, K Sano, T Temma, M Ueda, H Saji, K Togashi
AIM: To investigate whether delayed scanning at approximately 90 minutes post-injection of (68)Ga-labelled 1,4,7,10-tetraazacyclododecane-N,N',N″,N‴-tetraacetic acid-d-Phe(1)-Tyr(3)-octreotide (DOTATOC) had any clinical benefits regarding the evaluation of neuroendocrine tumours (NETs), relative to conventional combined positron-emission tomography (PET) and computed tomography (CT) at 60 minutes post-injection. MATERIALS AND METHODS: Fifty-four patients who underwent DOTATOC-PET/CT for suspected or known NETs were retrospectively reviewed...
October 2016: Clinical Radiology
Lukasz Liszka, Slawomir Mrowiec, Katarzyna Kusnierz, Maciej Kajor
BACKGROUND: There is no universally accepted protocol for gross examination of pancreaticoduodenectomy specimens. Standardized protocol (SP), known as Leeds Pathology Protocol, was previously validated in pancreatic adenocarcinoma. In this study we aimed to assess usefulness of SP in a series of specimens with pancreatic, ampullary, and duodenal malignant neoplasms other than adenocarcinomas. MATERIALS AND METHODS: SP was based on multi-colour inking and serial slicing of the specimens in a plane perpendicular to the duodenal axis...
May 16, 2016: Histology and Histopathology
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
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