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Neuroendocrine Liver Metastases

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https://www.readbyqxmd.com/read/29675259/successful-neoadjuvant-peptide-receptor-radionuclide-therapy-for-an-inoperable-pancreatic-neuroendocrine-tumour
#1
Tiago Nunes da Silva, M L F van Velthuysen, Casper H J van Eijck, Jaap J Teunissen, J Hofland, Wouter W de Herder
Non-functional pancreatic neuroendocrine tumours (NETs) can present with advanced local or distant (metastatic) disease limiting the possibility of surgical cure. Several treatment options have been used in experimental neoadjuvant settings to improve the outcomes in such cases. Peptide receptor radionuclide therapy (PPRT) using beta emitting radiolabelled somatostatin analogues has been used in progressive pancreatic NETs. We report a 55-year-old female patient with a 12.8 cm pancreatic NET with significant local stomach and superior mesenteric vein compression and liver metastases...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29663723/intraocular-metastasis-of-medullary-thyroid-carcinoma-investigated-by-transscleral-fine-needle-aspiration-a-case-report-and-review-of-the-literature
#2
Małgorzata Gajdzis, Nathalie Cassoux, Maria Lesnik, Caroline Hoffmann, Nathalie Badois, Paweł Gajdzis, Jerzy Klijanienko
Medullary thyroid carcinoma occurs in a sporadic setting and may also be inherited in an autosomal dominant fashion, which is related with germline mutations of the RET gene. Metastases are often present at the time of a diagnosis-most frequently within the cervical lymph nodes, followed by the liver, lungs, and bones. Intraocular metastases are extremely rare. We present a case of choroidal metastasis as a first presentation of disease progression in a patient with Multiple Endocrine Neoplasia type 2A syndrome (MEN2A) who had undergone thyroidectomy 33 years earlier for medullary thyroid carcinoma...
April 16, 2018: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29662318/rare-malignant-insulinoma-with-multiple-liver-metastases-derived-from-ectopic-pancreas-3-year-follow-up-and-literature-review
#3
Qing Liu, Jianghui Duan, Yumin Zheng, Jie Luo, Xiaopin Cai, Huangying Tan
Here, we report the diagnosis and treatment of a very rare case of malignant insulinoma derived from ectopic pancreas. A middle-aged woman presented with a 6-year history of recurrent hypoglycemia with multiple lesions in liver. Admission workup revealed elevated serum insulin and C-peptide, as well as multiple lesions in the liver (largest being 4.3 cm), enlarged lymph nodes around the pancreas, and a lesion (of 3.5 cm) at the proximal jejunum, as shown by contrast computed tomography (CT). Liver biopsy showed the lesions to be well-differentiated neuroendocrine tumors, grade G1...
2018: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29629320/combined-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-followed-by-left-trisectionectomy-and-whipple-operation-for-pnet
#4
Ren Ji, Shi Zuo, Siyuan Qiu, Ping Li, Albert Chan, William Sharr, Chung Mau Lo
Pancreatic neuroendocrine tumor (PNET) is slow-growing, and account only for 2% of all pancreatic primary tumors. Surgical resection is still the only curative treatment for PNET patients. Unfortunately, most of PNETs was found with unresectable multiple liver metastases and extrahepatic metastasis as their characteristics of non-functional and asymptomatic. With advances in liver surgery in these years, especially combined associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), provide a new curative surgical treatment for PNET with liver metastases patient...
February 2018: Gland Surgery
https://www.readbyqxmd.com/read/29629319/liver-transplantation-for-unresectable-pancreatic-neuroendocrine-tumors-with-liver-metastases-in-an-era-of-transplant-oncology
#5
REVIEW
Keita Shimata, Yasuhiko Sugawara, Taizo Hibi
Patients with pancreatic neuroendocrine tumors (pNETs) very often present with a metastatic disease at the first diagnosis. Liver transplantation (LT) for unresectable pNET with liver metastases (pNETLM) has been described to prolong survival in highly selected patients, although outcomes were worse than those of patients who underwent LT for gastrointestinal NETLM (GI-NETLM). In this review, several proposed criteria are described with their rationale and controversies. Most of the data used to establish these criteria do not reflect the recent improvements of non-surgical treatments that has changed the landscape of treatment for pNETs, including the development of peptide receptor radionuclide therapy and molecular-targeted agents (sunitinib and everolimus)...
February 2018: Gland Surgery
https://www.readbyqxmd.com/read/29629317/surgical-management-of-neuroendocrine-tumor-associated-liver-metastases-a-review
#6
REVIEW
Miu Yee Chan, Ka Wing Ma, Albert Chan
Liver metastasis is common among patients who suffer from neuroendocrine tumors (NETs). Radical surgery is the standard treatment whenever possible but there is still controversies concerning the treatment strategies such as resection of the primary, role of debulking surgery, liver transplantation (LT) and neoadjuvant or adjuvant therapies. This article aims to review the current evidence available, together with some latest updates, focusing on the surgical management.
February 2018: Gland Surgery
https://www.readbyqxmd.com/read/29629316/management-of-functional-neuroendocrine-tumors-of-the-pancreas
#7
REVIEW
Kjell Öberg
Pancreatic neuroendocrine tumors (pNETs) constitute a heterogenous group of malignancies with varying clinical presentation, tumor biology and prognosis. The incidence of pNETs has steadily increased during the last decades with an estimated incidence 2012 of 4.8/100,000. Recent whole genome sequencing of pNETs has demonstrated mutations in the DNA repair genes MUTYH and point mutations and gene fusions in four main pathways from chromatin remodeling, DNA damage repair, activation of mechanistic target of rapamycin (mTOR) signaling and the telomere maintenance...
February 2018: Gland Surgery
https://www.readbyqxmd.com/read/29626307/preoperative-fluorouracil-doxorubicin-and-streptozocin-for-the-treatment-of-pancreatic-neuroendocrine-liver-metastases
#8
Jordan M Cloyd, Kiyohiko Omichi, Takashi Mizuno, Yoshikuni Kawaguchi, Ching-Wei D Tzeng, Claudius Conrad, Yun Shin Chun, Thomas A Aloia, Matthew H G Katz, Jeffrey E Lee, Daniel Halperin, James Yao, Jean-Nicolas Vauthey, Arvind Dasari
INTRODUCTION: While preoperative chemotherapy is frequently utilized before resection of non-neuroendocrine liver metastases, patients with resectable neuroendocrine liver metastases typically undergo surgery first. FAS is a cytotoxic chemotherapy regimen that is associated with substantial response rates in locally advanced and metastatic pancreatic neuroendocrine tumors. METHODS: All patients who underwent R0/R1 resection of pancreatic neuroendocrine liver metastases at a single institution between 1998 and 2015 were included...
April 6, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29619528/grade-2-pancreatic-neuroendocrine-tumors-overbroad-scope-of-ki-67-index-according-to-mri-features
#9
Yabin Hu, Shengxiang Rao, Xiaolin Xu, Yibo Tang, Mengsu Zeng
PURPOSE: To evaluate the value of MR imaging features in stratifying Grade 2 (G2) pancreatic neuroendocrine tumors (PNETs) using the 5% cut-off value of the Ki-67 index as reference standards. MATERIALS AND METHODS: Between January 2010 and October 2016, 41 G2 PNET patients (One patient had 3 tumors) with preoperative MR imaging were included. Tumor grading was based on the revised 2016 World Health Organization classification of PNETs. MR imaging features included size, shape, consistency, T1-w and T2-w signal intensities, enhancement pattern, apparent diffusion coefficient (ADC) ratios (tumor/normal pancreatic parenchyma)...
April 4, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29570184/-surgical-treatment-of-secondary-liver-malignancies
#10
Gyula Végsõ, Laura Fekete, Imre Fehérvári, Zoltán Máthé
Surgical treatment of liver metastases, under certain conditions, can be a step of a multidisciplinary treatment strategy for advanced malignant disease. Nevertheless, it is not the same if metachronous or synchronous metastases are planned to be treated. Indications for surgery are the most clearly defined and accepted in cases of colorectal and neuroendocrine liver metastases. At the same time, the steps of the traditional oncotherapy has changed in the management of synchronous colorectal metastases: the novel concept of the treatment strategy is removing the liver metastases before the colorectal primary...
March 23, 2018: Magyar Onkologia
https://www.readbyqxmd.com/read/29560571/outcomes-of-cytoreductive-surgery-for-metastatic-low-grade-neuroendocrine-tumors-in-the-setting-of-extrahepatic-metastases
#11
David L Chan, Matthew Dixon, Calvin H L Law, Serge Koujanian, Kaitlyn A Beyfuss, Simron Singh, Sten Myrehaug, Julie Hallet
BACKGROUND: Neuroendocrine tumors (NETs) have a uniquely indolent biology. Management focuses on tumor and hormonal burden reduction. Data on cytoreduction with extrahepatic disease remain limited. OBJECTIVE: We sought to define the outcomes of cytoreduction for metastatic NETs with extrahepatic metastases. METHODS: Patients undergoing cytoreductive surgery for grade 1 or 2 NETs with extrahepatic metastases (with or without intrahepatic disease) were identified from an institutional database (2003-2014)...
March 20, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29545717/utility-of-ct-in-differentiating-liver-metastases-of-well-differentiated-gastroenteropancreatic-neuroendocrine-neoplasms-from-poorly-differentiated-neuroendocrine-neoplasms
#12
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
https://www.readbyqxmd.com/read/29532242/vertebral-metastases-from-neuroendocrine-tumours-how-to-avoid-false-positives-on-68-ga-dota-toc-pet-using-ct-pattern-analysis
#13
Mathieu Gauthé, Nathalie Testart Dardel, Fernando Ruiz Santiago, Jessica Ohnona, Valérie Nataf, Françoise Montravers, Jean-Noël Talbot
OBJECTIVES: To develop criteria to improve discrimination between vertebral metastases from neuroendocrine tumours (NETs) and benign bone lesions on PET combined with CT using DOTA-D-Phe1 -Tyr3 -octreotide labelled with gallium-68 (68 Ga-DOTA-TOC). METHODS: In 535 NET patients,68 Ga-DOTA-TOC PET/CT examinations were reviewed retrospectively for vertebral CT lesions and/or PET foci. For each vertebral PET abnormality, appearance on CT, biological volume (BV), standardized uptake value (SUVmax ) and ratios to those of reference organs were determined...
March 12, 2018: European Radiology
https://www.readbyqxmd.com/read/29513039/retreatment-with-peptide-receptor-radionuclide-therapy-in-patients-with-progressing-neuroendocrine-tumours-efficacy-and-prognostic-factors-for-response
#14
Emily Vaughan, Joseph Machta, Martin Walker, Christos Toumpanakis, Martyn Caplin, Shaunak Navalkissoor
OBJECTIVE: To evaluate the efficacy and toxicity of a repeat peptide receptor radionuclide therapy (PRRT) course in neuroendocrine tumour patients who have progressed following previous PRRT and to identify factors contributing to retreatment outcomes. METHODS: This was a retrospective analysis of 47 consecutive patients who had been treated with PRRT (PRRT1) and following disease progression were retreated with a second course of PRRT (PRRT2). We reviewed patient, tumour and treatment characteristics, time to progression after PRRT1 and PRRT2, overall survival and toxicity...
March 20, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29509220/valvular-unvolvement-in-carcinoid-disease-a-case-report
#15
Saoussen Antit, Lilia Zakhama, Sarra Chenik, Mohamed Saadi, Ahmed Houmed, Samar Mohamed, Elhem Boussabeh, Moez Thameur, Soraya Ben Youssef
Carcinoid tumors are rare, mainly located in the gastrointestinal tract particularly in the small intestine. Cardiac involvement, fairly frequent and usually affecting right sided heart valves, had a poor prognosis that is improved by an earlier detection and valve surgery. We report the case of a 50-years old woman with neuroendocrine tumor and liver metastases, in whom carcinoid involvement of the right heart was diagnosed following exertional dyspnea. She had dilated right cavities, severe tricuspid regurgitation, mild tricuspid stenosis and a moderate pulmonary stenosis...
May 2017: La Tunisie Médicale
https://www.readbyqxmd.com/read/29503572/role-of-palliative-resection-of-the-primary-pancreatic-neuroendocrine-tumor-in-patients-with-unresectable-metastatic-liver-disease-a-systematic-review-and-meta-analysis
#16
Bo Zhou, Canyang Zhan, Yuan Ding, Sheng Yan, Shusen Zheng
Background: Treatment for pancreatic neuroendocrine tumors (PNETs) in patients with unresectable metastatic liver disease has long been a controversial issue. This systematic review aims to summarize the existing evidence concerning the value of primary tumor resection in this group of patients. Methods: A systematic review of the literature and a meta-analysis were performed. The PubMed and Cochrane databases were searched to identify articles that compared palliative primary tumor resection and nonsurgical regimens in patients with PNETs and unresectable liver metastases...
2018: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29496075/yttrium-90-radioembolization-for-unresectable-metastatic-neuroendocrine-liver-tumor-a-systematic-review
#17
REVIEW
Zhongzhi Jia, Weiping Wang
OBJECTIVE: To evaluate the value of yttrium-90 (90 Y) microspheres in the management of unresectable liver metastases secondary to neuroendocrine tumors (NETs). MATERIALS AND METHODS: PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and the "gray" literature (Google Scholar) were searched for all studies related to 90 Y therapy for unresectable liver metastases of NETs. RESULTS: A total of 11 studies and 7 abstracts involving 870 patients were included in the final analysis...
March 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29491456/genetic-heterogeneity-of-primary-lesion-and-metastasis-in-small-intestine-neuroendocrine-tumors
#18
Dirk Walter, Patrick N Harter, Florian Battke, Ria Winkelmann, Markus Schneider, Katharina Holzer, Christine Koch, Jörg Bojunga, Stefan Zeuzem, Martin Leo Hansmann, Jan Peveling-Oberhag, Oliver Waidmann
Data on intratumoral heterogeneity of small intestine neuroendocrine tumors (SI-NETs) and related liver metastasis are limited. The aim of this study was to characterize genetic heterogeneity of 5 patients with SI-NETs. Therefore, formalin-fixed, paraffin-embedded tissue samples of primary and metastatic lesions as well as benign liver of five patients with synchronously metastasized, well differentiated SI-NETs were analyzed with whole exome sequencing. For one patient, chip based 850k whole DNA methylome analysis was performed of primary and metastatic tumor tissue as well as control tissue...
February 28, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29491050/update-on-surgical-management-of-small-bowel-neuroendocrine-tumors
#19
REVIEW
Demetrios Moris, Ioannis Ntanasis-Stathopoulos, Diamantis I Tsilimigras, Stylianos Vagios, Andreas Karamitros, Georgios Karaolanis, John Griniatsos, Alexandros Papalampros, Ioannis Papaconstantinou, Georgios K Glantzounis, Eleftherios Spartalis, Dan G Blazer, Evangelos Felekouras
The widespread use of endoscopy and imaging in combination with the continuous update of the staging systems for neuroendocrine tumors has led to an increase in the incidence of small intestinal neuroendocrine tumors (si-NENs) globally. Despite high survival rates, severe complications may occur even in early stages due to the anatomic location of the primary site and the desmoplastic reaction. Surgery plays a central role in the management of patients with si-NENs. Excision of locoregional disease along with extensive lymph node dissection should be performed in fit patients, even in the presence of metastases...
March 2018: Anticancer Research
https://www.readbyqxmd.com/read/29485441/68ga-dotatate-pet-ct-imaging-of-elastofibroma-dorsi
#20
Mitsutomi Ishiyama, Hubert Vesselle
Sixty six-year-old woman status post ileocecal resection for well-differentiated neuroendocrine tumor in the terminal ileum 7 years ago, who is on octreotide therapy for liver metastases. Ga DOTATATE PET/CT showed soft tissue masses with mildly increased radiotracer uptake in the bilateral subscapular/infrascapular regions. In retrospective image review, these soft tissue masses were first noted 7 years prior and have gradually increased in size over the years. Given the characteristic location and imaging findings, these masses are consistent with benign elastofibroma dorsi instead of metastasis...
February 27, 2018: Clinical Nuclear Medicine
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