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hepatic metastases neuroendocrin tumor

Yasunori Minami, Tomohiro Minami, Hirokazu Chishina, Masashi Kono, Tadaaki Arizumi, Masahiro Takita, Norihisa Yada, Satoru Hagiwara, Hiroshi Ida, Kazuomi Ueshima, Naoshi Nishida, Masatoshi Kudo
OBJECTIVE: Radiofrequency ablation (RFA) induces gas bubbles in ablation zones, and the ablative margin cannot be evaluated accurately on ultrasound (US) during and immediately after RFA. This study assessed the usefulness of US-US fusion imaging to visualize the ablative margin of RFA for liver metastasis. METHODS: RFA guided by US-US fusion imaging was performed on 12 targeted tumors in 10 patients. Secondary hepatic malignancies included patients with colorectal cancer (n = 4), breast cancer (n = 2), lung cancer (n = 1), gastrointestinal stromal tumor (n = 1), pancreatic neuroendocrine tumor (n = 1), and adrenocortical carcinoma (n = 1)...
2016: Digestive Diseases
Anirban Mukherjee, Krishan Kant Agarwal, Chandrasekhar Bal, Rakesh Kumar
Neuroendocrine tumors (NETs) are rare heterogeneous neoplasm of variable aggressiveness. A 55-year-old woman underwent Ga-DOTANOC PET-CT for suspected NET, which revealed DOTANOC-avid soft tissue mass in the second part of the duodenum with multiple hepatic metastases. Another non-DOTANOC-avid abdominal mass and hypodense lesion in segment VI of the liver were noted. For further evaluation, FDG PET-CT was performed, which revealed increased uptake in the abdominal mass and lesion in segment VI of the liver...
October 5, 2016: Clinical Nuclear Medicine
Nikolas M Eleftheriou, Jonas Sjölund, Matteo Bocci, Eliane Cortez, Se-Jin Lee, Sara I Cunha, Kristian Pietras
Angiogenesis occurs early in tumor development, sustains primary tumor growth and provides a route for metastatic escape. The TGF-β family receptors modulate angiogenesis via endothelial-cell specific pathways. Here we investigate the interaction of two such receptors, ALK1 and endoglin, in pancreatic neuroendocrine tumors (PanNET). Independently, ALK1 and endoglin deficiencies exhibited genetically divergent phenotypes, while both highly correlate to an endothelial metagene in human and mouse PanNETs. A concurrent deficiency of both receptors synergistically decreased tumor burden to a greater extent than either individual knockdown...
October 12, 2016: Oncotarget
James X Chen, Steven Rose, Sarah B White, Ghassan El-Haddad, Nicholas Fidelman, Hooman Yarmohammadi, Winifred Hwang, Daniel Y Sze, Nishita Kothary, Kristen Stashek, E Paul Wileyto, Riad Salem, David C Metz, Michael C Soulen
PURPOSE: The purpose of the study was to evaluate prognostic factors for survival outcomes following embolotherapy for neuroendocrine tumor (NET) liver metastases. MATERIALS AND METHODS: This was a multicenter retrospective study of 155 patients (60 years mean age, 57 % male) with NET liver metastases from pancreas (n = 71), gut (n = 68), lung (n = 8), or other/unknown (n = 8) primary sites treated with conventional transarterial chemoembolization (TACE, n = 50), transarterial radioembolization (TARE, n = 64), or transarterial embolization (TAE, n = 41) between 2004 and 2015...
October 13, 2016: Cardiovascular and Interventional Radiology
Cynthia R Fata, Raul S Gonzalez, Eric Liu, Justin M Cates, Chanjuan Shi
Mesenteric tumor deposits (MTDs) are not included in the American Joint Committee on Cancer (AJCC) staging system for midgut small intestinal neuroendocrine tumors (NETs). We examined the prognostic significance of MTDs associated with midgut NETs. Hematoxylin and eosin slides from 132 resected jejunal/ileal NETs were reviewed for AJCC tumor stage, lymph node (LN) metastasis, MTDs, and hepatic metastases. MTDs were defined as discrete irregular mesenteric tumor nodules discontinuous from the primary tumor. Clinical or pathologic evidence of metastases and survival data were abstracted from electronic medical records...
September 28, 2016: American Journal of Surgical Pathology
Steve Malangone, Christopher J Campen
A 60-year-old man initially presented with pain in the right upper quadrant in October 2010. A computed tomography (CT) scan of the abdomen pelvis completed at that time showed a mass at the junction of the body and tail of the pancreas and multiple large liver lesions. A CT-guided liver biopsy revealed low-grade neuroendocrine carcinoma. The patient was initially started on systemic treatment with sunitinib (Sutent) and octreotide. He developed intolerable side effects, including nausea and migraine. Therapy was discontinued in October 2011, when a CT scan revealed evidence of disease progression...
November 2015: Journal of the Advanced Practitioner in Oncology
Alexander C Schippers, Federico Collettini, Ingo G Steffen, Gero Wieners, Timm Denecke, Marianne Pavel, Peter Wust, Bernhard Gebauer
PURPOSE: To evaluate efficacy of computed tomography (CT)-guided high-dose-rate brachytherapy (HDRBT) of neuroendocrine liver metastases (NELM) with the goal of local tumor control (LTC). MATERIALS AND METHODS: This retrospective study included all patients with unresectable NELM treated with CT-guided HDRBT between January 2007 and April 2015. Magnetic resonance imaging follow-up was performed 6 weeks after ablation and then every 3 months. The primary endpoint was LTC...
September 16, 2016: Journal of Vascular and Interventional Radiology: JVIR
Johann Dréanic, Céline Lepère, Mostafa El Hajjam, Hervé Gouya, Philippe Rougier, Romain Coriat
VIPoma is a rare neuroendocrine tumor (NET) with a high potential to develop hepatic metastases and poor prognosis. The primitive tumor is nonsymptomatic and usually localized within the pancreas. Liver metastasis drives the prognosis and induces profuse watery diarrhea or renal failure. We herein present severe renal failure or diarrhea in two patients hospitalized in intensive care justifying emergency treatment of liver metastasis. The two patients experienced severe diarrhea due to a hypersecretion of vasoactive intestinal peptide (VIP) from liver metastasis released into the blood circulation...
September 2016: Therapeutic Advances in Medical Oncology
Elahe Pirayesh, Mahasti Amoui, Majid Assadi
The diagnostic value of somatostatin receptor scintigraphy (SRS) in detecting tumors has been assessed in a number of studies. We present a 30-year-old female with a history of eight months cough and left shoulder pain. Radiologic evaluation showed pulmonary mass and hepatic lesions, which were pathologically diagnosed as neuroendocrine carcinoma. 99mTc-octreotide scan demonstrated that the pulmonary lesion was positive for somatostatin receptor (SSTR), while the liver metastases were SSTR negative. The present case highlights the significance of a differential uptake pattern by somatostatin receptors in SRS in patients with neuroendocrine tumors...
October 5, 2015: Molecular Imaging and Radionuclide Therapy
Katherine Y Fan, Aaron T Wild, Vivek G Halappa, Rachit Kumar, Susannah Ellsworth, Mark Ziegler, Tanu Garg, Lauren M Rosati, Zheng Su, Amy Hacker-Prietz, Timothy M Pawlik, David P Cosgrove, Kelvin K Hong, Ihab R Kamel, Jean-Francois Geschwind, Joseph M Herman
OBJECTIVE: Yttrium-90 (Y-90) radioembolization is an emerging treatment option for unresectable neuroendocrine liver metastases (NELM). However, the data regarding this treatment are currently limited. This study evaluates the efficacy and tolerability of Y-90 radioembolization and identifies prognostic factors for radiographic response and survival. METHODS AND MATERIALS: Thirty-eight patients underwent Y-90 radioembolization for NELM at our institution between April 2004 and February 2012...
September 2016: Contemporary Clinical Trials
Mina S Makary, Jordan Kapke, Vedat Yildiz, Xueliang Pan, Joshua D Dowell
PURPOSE: To compare outcomes of conventional transarterial chemoembolization with drug-eluting bead (DEB) chemoembolization for treatment of neuroendocrine tumor liver metastases. MATERIALS AND METHODS: This single-center, retrospective study evaluated 177 transarterial chemoembolization treatments (78 conventional chemoembolization treatments using ethiodized oil-based cisplatin, mitomycin C, and doxorubicin and 99 DEB chemoembolization treatments using doxorubicin-loaded 100-300 μm DEBs) from 2012 to 2015...
September 2016: Journal of Vascular and Interventional Radiology: JVIR
Sonya Sergieva, Bozhil Robev, Milena Dimcheva, Albena Fakirova, Radka Hristoskova
Neuroendocrine tumors (NETs) of the thorax including bronchial and thymic tumors belong to foregut NETs. Limited loco-regional thoracic NETs can be resected with surgery, but in extensive metastatic disease the treatment is mainly palliative. A high incidence and density of somatostatin receptors (SSTR2, SSTR3, and SSTR5) are found in thoracic NETs. The purpose of this study was to evaluate the role of SPECT-CT somatostatin receptor scintigraphy (SRS) with 99mTc-Tektrotyd for imaging, staging and follow up of patients with bronchial and thymic neuroendocrine tumors...
2016: Nuclear Medicine Review. Central & Eastern Europe
Marius L Calin, Aziz Sadiq, Gabriel Arevalo, Rocio Fuentes, Vincent L Flanders, Niraj Gupta, Baongoc Nasri, Kirpal Singh
INTRODUCTION: Surgery for liver metastases in pancreatic neuroendocrine tumor (PNET) improves overall survival rate. We present the first case report for robotic multivisceral resection of distal pancreas, spleen, and left liver for metastatic PNET. MATERIALS AND METHODS: We present a case of 52-year-old female diagnosed with PNET in the pancreatic neck metastatic to the liver, responding to somatostatin and bland embolization, who underwent surgical debulking using da Vinci robotic platform...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Mio Kitano, Gail W Davidson, Lawrence A Shirley, Carl R Schmidt, Gregory E Guy, Hooman Khabiri, Joshua D Dowell, Manisha H Shah, Mark Bloomston
BACKGROUND: Neuroendocrine tumors (NETs) have a propensity to metastasize to the liver, often resulting in massive tumor burden and hepatic dysfunction. While transarterial chemoembolization (TACE) is effective in treating patients with NET metastatic to the liver, there are limited data on its utility and benefit in patients with large hepatic involvement. The aim of our study was to determine the clinical benefit and complication rate of TACE in patients with massive hepatic tumor burden...
July 8, 2016: Annals of Surgical Oncology
L P Lavelle, A C O'Neill, C J McMahon, C P Cantwell, E J Heffernan, D E Malone, L Daly, S J Skehan
AIM: To assess if diffusion-weighted imaging (DWI) alone could be used for follow-up of neuroendocrine hepatic metastases. MATERIAL AND METHODS: This was a retrospective study, approved by the institutional review board. Twenty-two patients with neuroendocrine liver metastases who had undergone more than one liver magnetic resonance imaging (MRI) examination, (including DWI and using hepatocyte-specific contrast medium) were evaluated. Up to five metastases were measured at baseline and at each subsequent examination...
September 2016: Clinical Radiology
S Milin, L Brunaud, X Orry, C Bastien, M Klein, L Bresler, V Laurent
PURPOSE: Identifying liver metastases from neuroendocrine tumors (NETs) is a pretherapeutic challenge in patients who are candidates for liver resection. The aims of our study are to characterize and determine the frequency of different MRI characteristics of liver metastases caused by NETs in a lesion-by-lesion analysis and to determine the frequency of monomorphous and polymorphous metastases in a patient-by-patient analysis. METHODS: This retrospective study involved 47 patients with liver metastases arising from histologically confirmed NETs...
June 17, 2016: Abdominal Radiology
Smit Singla, Charles M LeVea, Venkata K Pokuri, Kristopher M Attwood, Michael M Wach, Garin M Tomaszewski, Boris Kuvshinoff, Renuka Iyer
BACKGROUND: Neuroendocrine tumors (NETs) metastatic to the liver are treated with transarterial radioembolization (TARE) using yttrium-90 (Y-90) microspheres or transarterial chemoembolization (TACE). However the criteria for patient selection are not well defined. We sought to determine if Ki67 score could help select patients for one therapy over the other in the management of hepatic neuroendocrine metastases. METHODS: Single institution analysis of patients treated with Y-90 or TACE between 2001 and 2014...
June 2016: Journal of Gastrointestinal Oncology
Asahiro Morishita, Hirohito Yoneyama, Takako Nomura, Teppei Sakamoto, Koji Fujita, Joji Tani, Hisaaki Miyoshi, Reiji Haba, Tsutomu Masaki
We herein present a case of an 87-year-old patient with multiple liver tumors identified on abdominal ultrasound. The assessment performed on admission included physical examination, computed tomography (CT) during hepatic angiography and CT during arterial portography. The examination revealed contrast enhancement of a proportion of the liver tumors (20 mm maximum diameter) during the arterial phase and mild contrast washout of those tumors during the delayed phase. On contrast-enhanced magnetic resonance imaging using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid, certain liver tumors exhibited contrast enhancement during the early phase and contrast washout during the hepatocyte phase in both lobes...
June 2016: Molecular and Clinical Oncology
Murat Fani Bozkurt, Bilge Volkan Salanci, Ömer Uğur
Intra-arterial radionuclide therapies serve essentially as internal radiation treatment options for both primary and metastatic liver tumors, which imply delivering implantable radioactive microspheres into branches of hepatic arteries that feed liver tumors to provide a high dose of targeted radiation to tumor tissue, while sparing the healthy liver tissue from hazardous effects of radiation. The principle of this therapeutic option depends on the unique preferential arterial supply of malignant liver tumors in contrast with mostly portal venous supply of normal hepatocytes as well as excess amount of arterial neovascularization in the tumor bed...
July 2016: Seminars in Nuclear Medicine
Hee Woo Lee, Jun-Won Chung, Yoon Jae Kim, Kwang Ahn Kwon, Eui Joo Kim, Keon Kuk Kim, Woon Ki Lee, Sun Jin Sym
A 34-year-old man was referred to our hospital with gastric polypoid lesions and biopsy-confirmed neuroendocrine tumor (NET). Computed tomography (CT) revealed a 3×3.5×8-cm retroperitoneal mass behind the pancreas, with multiple hepatic metastases. His serum gastrin level was elevated to 1,396 pg/mL. We performed a wedge resection of the stomach, a right hemi-hepatectomy, and a retroperitoneal mass excision. After careful review of the clinical, radiological, histopathological, and immunohistochemical findings, peripancreatic gastrinoma, and synchronous gastric NET were ultimately diagnosed...
May 20, 2016: Clinical Endoscopy
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