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hepatic metastases neuroendocrin tumor

Yong Cui, Xiaoting Li, Shunyu Gao, Zhongwu Li, Yanling Li, Ming Lu, Yingshi Sun
Objective: To determine the capability of dynamic enhanced computed tomography (CT) to differentiate liver metastases (LMs) of well-differentiated from poorly-differentiated gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Methods: Patients with LMs of GEP-NENs who underwent dynamic enhanced CT examination in Peking University Cancer Hospital from January 2009 to October 2015 were included and data were retrospectively analyzed. We assessed the qualitative and quantitative CT features to identify the significant differentiating CT features of LMs of poorly-differentiated GEP-NENs from those of well-differentiated GEP-NENs using univariate analysis and a multivariate logistic regression model...
February 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Yang Lv, Cheng Huang, Haizhou Xu, Xu Han, Lei Zhang, Weilin Mao, Yuan Ji, Dayong Jin, Wenhui Lou, Xuefeng Xu
Aims: We aim to describe the clinicopathological characteristics of hepatic neuroendocrine tumors (HNETs) and evaluate the relevant prognosis-related factors. Methods: The clinical data of 81 consecutive patients with primary or metastatic HNETs from March 2000 to July 2014 were retrospectively analyzed. Results: The mean (SD) age was 59.68 (11.64) years, 69.15% were men. The percentages of Grade G1, G2 and G3 tumors were 4.94%, 25.93% and 69.13%, respectively. Thirty-five cases were primary HNETs. Primary HNETs were more common in patients with larger tumors, lymph nodes invasions, tumor necrosis and portal vein tumor thrombus...
2018: Journal of Cancer
Sree Harsha Tirumani, Jyothi P Jagannathan, Marta Braschi-Amirfarzan, Lei Qin, Patricia Balthazar, Nikhil H Ramaiya, Atul B Shinagare
OBJECTIVE: To compare hepatocellular phase imaging after intravenous gadoxetate disodium with other MRI pulse sequences and with extracellular agent for assessing hepatic metastases from gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). MATERIALS AND METHODS: In this IRB-approved, HIPAA-compliant retrospective study, we included 30 patients (15 women, mean age: 58 years, range 44-77 years) with GEP-NEN metastatic to the liver, who underwent MRI with gadoxetate disodium...
February 22, 2018: Abdominal Radiology
F Weber, H Dralle
Neuroendocrine tumors of the small intestines are a rare disease with an incidence of 1 per 100,000 of the population; however, they account for over 20% of all neuroendocrine tumors and are the most common malignancy of the small intestines. Diagnosis is often made at a late stage of the disease, as the clinical symptoms are unspecific. Approximately one third of all patients show hepatic metastases at the time of diagnosis. There is no correlation between tumor size and tumor stage. Even small tumors <10 mm harbor the risk for lymphatic and distant metastases so that the extent of surgery is not determined by the size of the primary tumor...
February 20, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Hyun S Kim, Walid L Shaib, Chao Zhang, Ganji Purnachandra Nagaraju, Christina Wu, Olatunji B Alese, Zhengjia Chen, Edith Brutcher, Meredith Renfroe, Bassel F El-Rayes
BACKGROUND: Neuroendocrine tumors (NETs) metastasize to the liver. Everolimus and selective internal radioembolization (SIRT) are approved treatments. Pasireotide is a somatostatin analogue with an affinity for somatostatin receptors 1, 2, 3, and 5. Everolimus and pasireotide may potentiate SIRT radiosensitization and inhibit rebound angiogenesis. This study evaluated the safety of pasireotide, everolimus, and SIRT. METHODS: This 3 + 3 phase 1 trial evaluated 3 dose levels of everolimus (2...
February 16, 2018: Cancer
S Deguelte, L de Mestier, O Hentic, J Cros, R Lebtahi, P Hammel, R Kianmanesh
The management of patients with pancreatic neuroendocrine tumor (PNET), whether hormonally secretory or not, is multidisciplinary and often multimodal. Surgical treatment plays a central role because complete resection is the only potentially curative treatment. The choice of the therapeutic plan for a PNET requires precise localization of the primary tumor (which may sometimes be multiple in case of genetic predisposition), confirmation of the diagnosis of PNET, a search for metastases (mainly hepatic), and identification of the main histoprognostic factors...
January 31, 2018: Journal of Visceral Surgery
S Grozinsky-Glasberg, G Kaltsas, M Kaltsatou, N Lev-Cohain, A Klimov, V Vergadis, I Uri, A I Bloom, D J Gross
BACKGROUND: Liver metastases are common in patients with neuroendocrine tumors (NETs), having a negative impact on disease prognosis. The options for selective therapy in patients with unresectable multiple liver metastases are limited to TACE (transarterial chemoembolization), TAE (transarterial embolization), or SIRT (selective internal radiation therapy). AIM: To explore the clinical outcome, survival and safety of these therapies in NETs patients. METHODS: Retrospective case series of consecutive patients (mean age 56...
January 30, 2018: Endocrine
Carlo Sposito, Michele Droz Dit Busset, Davide Citterio, Marco Bongini, Vincenzo Mazzaferro
Liver metastases occur in nearly half of NET patients (MNETs) and heavily affect prognosis, with 5-yr. OS around 19-38%. Although it is difficult to show outcome differences for available treatments, due to the long course of disease, surgery for MNETs remains the most effective option in terms of survival and symptom control. Since MNETs frequently present as an oligo-metastatic, liver-limited disease, unresectable in 80% of cases, liver transplantation (LT) has emerged as a potential curative treatment. Nevertheless, experience with LT for MNETs is limited and burdened by highly heterogeneous outcomes and significant recurrence rate, mostly explained by the variability of selection criteria...
January 23, 2018: Reviews in Endocrine & Metabolic Disorders
Peng Liu, Xu Zhu, Jie Li, Ming Lu, Jiahua Leng, Ying Li, Jiangyuan Yu
Objective: To analyze the angiography appearance of liver metastases from gastroenteropancreatic neuroendocrine tumors (GEP-NETs), and evaluate the clinical efficacy and prognostic factors of interventional treatment for hepatic metastases. Methods: Fifty GEP-NETs patients with hepatic metastases were treated from January 2012 to December 2016, and received transarterial embolization (TAE) in the hepatic tumor or hepatic arterial infusion chemotherapy (HAIC). All patients received 179 times of the intervention therapy in total...
December 2017: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Riccardo De Robertis, Bogdan Maris, Nicolò Cardobi, Paolo Tinazzi Martini, Stefano Gobbo, Paola Capelli, Silvia Ortolani, Sara Cingarlini, Salvatore Paiella, Luca Landoni, Giovanni Butturini, Paolo Regi, Aldo Scarpa, Giampaolo Tortora, Mirko D'Onofrio
OBJECTIVES: To evaluate MRI derived whole-tumour histogram analysis parameters in predicting pancreatic neuroendocrine neoplasm (panNEN) grade and aggressiveness. METHODS: Pre-operative MR of 42 consecutive patients with panNEN >1 cm were retrospectively analysed. T1-/T2-weighted images and ADC maps were analysed. Histogram-derived parameters were compared to histopathological features using the Mann-Whitney U test. Diagnostic accuracy was assessed by ROC-AUC analysis; sensitivity and specificity were assessed for each histogram parameter...
January 19, 2018: European Radiology
T Lestra, L Kanagaratnam, S Mulé, A Janvier, H Brixi, G Cadiot, A Dohan, C Hoeffel
PURPOSE: To assess dimension measurement variability of liver metastases from neuroendocrine tumors (LMNET) on different magnetic resonance imaging (MRI) sequences. MATERIAL AND METHODS: In this institutional review board-approved retrospective study from January 2011 to December 2012, all liver MRI examinations performed at our department in patients with at least one measurable LMNET according to response evaluation criteria in solid tumors (RECIST1.1) were included...
January 12, 2018: Diagnostic and Interventional Imaging
Yong Cui, Zhong-Wu Li, Xiao-Ting Li, Shun-Yu Gao, Ying Li, Jie Li, Hui-Ci Zhu, Lei Tang, Kun Cao, Ying-Shi Sun
This study proposed to evaluate the feasibility of dynamic enhanced CT in differentiation of liver metastases of gastroenteropancreatic well-differentiated neuroendocrine tumors (GEP NETs) from GEP adenocarcinomas based on their characteristic features. CT images of 23 well-differentiated (G1 or G2) GEP NETs and 23 GEP adenocarcinomas patients with liver metastases were retrospectively reviewed. The distribution type, shape, intra-tumoral neovascularity, enhancement on hepatic artery phase, dynamic enhancement pattern and lymphadenopathy were subjective analyzed...
December 8, 2017: Oncotarget
F Kulali, A Semiz-Oysu, M Demir, M Segmen-Yilmaz, Y Bukte
PURPOSE: The purpose of this study was to describe the magnetic resonance imaging (MRI) findings including diffusion-weighted MRI of nonfunctional pancreatic neuroendocrine tumors (PanNETs) and their hepatic metastases, and investigate the relationships between MRI features and histopathological findings for each grade of PanNETs. MATERIALS AND METHODS: A total of 30 patients were included. There were 14 men and 16 women with a mean age of 61.60±11 (SD) years (range: 31-81years)...
December 16, 2017: Diagnostic and Interventional Imaging
Jenson Ma, Juan Martin Gimenez, Tyler Sandow, Daniel Devun, David Kirsch, Paul Gulotta, Patrick Gilbert, Dennis Kay
Background: Since the early 1990s, the minimally invasive image-guided therapies used in interventional oncology to treat hepatocellular carcinoma have continued to evolve. Additionally, the range of applications has been expanded to the treatment of hepatic metastases from colorectal cancer, neuroendocrine tumors, cholangiocarcinoma, breast cancer, melanoma, and sarcoma. Methods: We searched the literature to identify publications from 1990 to the present on various image-guided intraarterial therapies and their efficacy, as well as their role in the management of primary and secondary liver malignancies...
2017: Ochsner Journal
Anna-Karin Elf, Mats Andersson, Olof Henrikson, Oscar Jalnefjord, Maria Ljungberg, Johanna Svensson, Bo Wängberg, Viktor Johanson
BACKGROUND: Radioembolization (RE) with intra-arterial administration of (90)Y microspheres is a promising technique for the treatment of liver metastases from small intestinal neuroendocrine tumors (SI-NET) not amenable to surgery or local ablation. However, studies comparing RE to other loco-regional therapies are lacking. The aim of this randomized study was to compare the therapeutic response and safety after RE and bland hepatic arterial embolization (HAE), and to investigate early therapy-induced changes with diffusion-weighted MRI (DWI-MRI)...
November 22, 2017: World Journal of Surgery
Tatjana Schmidt, Julia M Schwarz, Martina Steurer, Martin Goetz, Susann-Cathrin Olthof, Nisar P Malek, Bita Boozari
Diagnostic imaging of jejuno-ileal neuroendocrine tumors (NETs) has been described as challenging. Follow-up requires the detection of metastatic spread as well as screening for local recurrence. Multimodal imaging concepts must often be applied.We report the case of a 45-year-old man with a history of ileal NET. At 2 points in follow-up of our patient, information provided by high-end ultrasound changed prognosis and treatment considerably: when positron emission tomography/computed tomography newly detected suspected hepatic metastases, contrast-enhanced ultrasound correctly identified the lesions as intrahepatic vascular shunts...
November 7, 2017: Zeitschrift Für Gastroenterologie
Yasunaru Sakuma, Naohiro Sata, Kazuhiro Endo, Yoshikazu Yasuda, Shinichiro Yokota, Yoshinori Hosoya, Atsushi Shimizu, Hirofumi Fujii, Daisuke Matsubara, Noriyoshi Fukushima, Shoko Asakawa, Yuuki Kawarai Shimada, Chieko Kawarai Lefor, Alan Kawarai Lefor
INTRODUCTION: Pancreatic neuroendocrine tumors are rare. Treatment includes aggressive local management of the primary lesion and metastases, and systemic somatostatin. This is the first report of an isolated metachronous metastasis to the adrenal gland from a pancreatic neuroendocrine tumor that presented 90 months after the primary tumor. PRESENTATION OF CASE: The patient presented as a 53yo man with a left upper quadrant mass and synchronous metastases to the spleen and liver (pancreatic neuroendocrine tumor T4N0M1, Stage IV), which were resected (CD56-, synaptophysin+, chromogranin+, Ki-67<1%)...
October 19, 2017: International Journal of Surgery Case Reports
Omer A M Saeed, Harvey Cramer, Xiaoyan Wang, Howard H Wu
BACKGROUND: Fine needle aspiration (FNA) is considered an excellent technique for documenting metastatic neuroendocrine tumors (NETs). This study aims to evaluate the accuracy of FNA in diagnosing metastatic NETs to the liver and determining the grade and origin of these metastases. METHODS: Our laboratory information system was searched from 1997 to 2016 to identify all cases of metastatic NETs to the liver that were sampled by FNA. The cytopathology and surgical pathology reports as well as the patients' electronic medical records were reviewed...
January 2018: Diagnostic Cytopathology
Chaan S Ng, Wei Wei, Cihan Duran, Payel Ghosh, Ella F Anderson, Adam G Chandler, James C Yao
OBJECTIVE: To assess the effects of bevacizumab and everolimus, individually and combined, on CT perfusion (CTp) parameters in liver metastases from neuroendocrine tumors (mNET) and normal liver. METHODS: This retrospective study comprised 27 evaluable patients with mNETs who had participated in a two-arm randomized clinical trial of mono-therapy with bevacizumab (Arm B) or everolimus (Arm E) for 3 weeks, followed by combination of both targeted agents. CTp was undertaken at baseline, 3 and 9 weeks, to evaluate blood flow (BF), blood volume (BV), mean transit time (MTT), permeability surface area product (PS), and hepatic arterial fraction (HAF) of mNET and normal liver, using a dual-input distributed parameter physiological model...
October 26, 2017: Abdominal Radiology
Erik Soule, Arya Bagherpour, Jerry Matteo
BACKGROUND: Neuroendocrine malignancy is indolent, yet relentless in its propensity to metastasize to the liver, where it may cause bizarre paraneoplastic syndromes. The pathophysiologic mechanism behind this predilection for hepatic metastasis is twofold: the portal venous system drains the most likely primary sites for neuroendocrine tumors, and the relatively immunosuppressed environment within the hepatic parenchyma is permissive for tumor growth. The standard of care for patients with metastatic neuroendocrine tumor is surgical resection of at least 90% of the tumor burden...
September 2017: Gastrointestinal Tumors
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