• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7117-7120
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• 2013

Background: This study hypothesized living in a poor neighborhood decreased the cause specific survival in individuals suffering from carcinoid carcinomas. Surveillance, Epidemiology and End Results (SEER) carcinoid carcinoma data were used to identify potential socioeconomic disparities in outcome. Materials and Methods: This study analyzed socioeconomic, staging and treatment factors available in the SEER database for carcinoid carcinomas. The Kaplan-Meier method was used to analyze time to events and the Kolmogorov-Smirnov test to compare survival curves. The Cox proportional hazard method was employed for multivariate analysis. Areas under the receiver operating characteristic curves (ROCs) were computed to screen the predictors for further analysis. Results: There were 38,546 patients diagnosed from 1973 to 2009 included in this study. The mean follow up time (S.D.) was 68.1 (70.7) months. SEER stage was the most predictive factor of outcome (ROC area of 0.79). 16.4% of patients were un-staged. Race/ethnicity, rural urban residence and county level family income were significant predictors of cause specific survival on multivariate analysis, these accounting for about 5% of the difference in actuarial cause specific survival at 20 years of follow up. Conclusions: This study found poorer cause specific survival of carcinoid carcinomas of individuals living in poor and rural neighborhoods.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2579-2581
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• 2016

Background: Neuroendocrine tumors represent 20% of primary lung neoplasms in some registries. According to the WHO classification of 2004, reconsidered for 2015, these lung tumors are divided into 4 groups: typical and atypical carcinoid, small cell and large cell neuroendocrine carcinomas. We report in this paper, for the first time in Lebanon, the distribution and the population characteristics of these tumors. Materials and Methods: This descriptive retrospective study concerned all the pulmonary neuroendocrine tumors (NET) with their characteristics diagnosed in $H\hat{o}tel$ Dieu de France in Beirut, Lebanon from 2001 to 2012, with attention to features like age, gender and subgroup. Results: Of 194 patients with pulmonary NET, 12.4% were typical carcinoid tumors, 3.6% atypical carcinoid, 66.5% small cell lung cancer, 7.7% combined small cell carcinomas and 9.8% large cell neuroendocrine tumors. The mean ages of patients were respectively 51.2 years in typical carcinoid, 64 years in atypical carcinoid, 64.2 years in small cell lung cancers, 67.2 in combined small cell lung cancer and 66.9 in large cells neuroendocrine tumors. The M/F sex ratios were respectively 0.3, 1.3, 1.4, 2.7 and 2.2. Conclusions: The characteristics of lung neuroendocrine tumors in our Lebanese institution are comparable to those reported in the literature.

• Tuberculosis and Respiratory Diseases
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• v.38 no.1
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• pp.74-82
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• 1991

Bronchial carcinoid is one of the unusual tumors of the lung, accounting for 1 percent of all lung tumors. Carcinoids, like small cell carcinomas, are generally considered to be derived from a neurosecretary type of cell of the respiratory epithelium, the Kulchtsky's cell. So, they are no longer classified as bronchial adenoma, and are recently grouped into the neuroendocrine group of tumors, the so-called APUD (Amine Precursor Uptake Decarboxylase) group of tumors. Although usually characterized by a slow growth pattern and a low incidence of metastatic disease, bronchial carcinoids should no longer be considered as beingn, and a much higher malignant behavior has been described with a special destignation of 'atypical carcinoid'. Bronchial carcinoids are histologically confirmed by the azurophil staining and the presence of the characteristic neurosecretary granule on electron microscopy. Recently we experienced two cases of bronchial carcinoid, the first case, being peripheral-located and histologically proven as atypical carcinoid, and the second, being central-located and hitologically typical. So we report these cases with a review of the literature.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.198-201
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• 2004

Neuroendocrine carcinomas are rare neoplasms of the hypopharynx. Neuroendocrine neoplasms are divided into four main types : carcinoid, atypical carcinoid, small cell carcinoma and paraganglioma. The diagnosis is primarily based on light microscopy and should be confirmed by immunohistochemical investigation. Small cell neuroendocrine carcinoma of the hypopharynx is extremely uncommon tumor and surgical results for this tumor have been disappointing. Chemotherapy and radiotherapy currently appear the most effective forms of therapy. We report our case of small cell neuroendocrine carcinoma of the hypopharynx with the brief review of literatures.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.806-811
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• 1992

The primary neuroendocrine carcinomas[NEC] of the lung are relatively rare. There are classified histologically into the following groups. 1] bronchial carcinoid, 2] well differentiated neuroendocrine carcinoma[WDNC], 3] intermediate cell neuroendocrine carci-noma[ICNC], 4] small cell neuroendocrie carcinoma[SCNC]. The NE cells can be found throughout the mucosa of the bronchial tree by the electron microscopy. By the immunocytochemistry, Neuron-specific enolase[NSE], serotonin, born-csin, and calcitonin are found in normal solitary NE cells and neuroepithelial bodies. The immunohistochemistry has the advantage that it can be applied on routine pathology specimens. The NSE was localized in all of the NE granule bearing tumors but also present in 57 per cent of the non NE carcinomas. Together the combination of chromogranin A, bombesin and NSE should provide an exellent signature for tumor cells expressing NE features, such as carcinoids and other NE carcinomas. We have experienced two cases of primary pulmonary NEC in 59 and 29 years old men. The former was admitted due to exertional dyspnea and left chest pain, the latter, newly developed mass on chest X-ray. They were treated by Lt pneumonectomy with LN dissection and RLL resection with LN dissection The postoperative diagnoses were could be confirmed by NSE study as NEC which were SCNEC and INEC in subgroups. The postoperative courses were uneventful.

• The Korean Journal of Cytopathology
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• v.2 no.2
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• pp.90-97
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• 1991

Liver is generally known as an organ which is most commonly involved by the metastic tumors. According to the tendency of using fine needle aspiration in the diagnosis of hepatic tumors, the differentital diagnosis between hepatocellular carcinoma and metastatic carcinoma frequently has been a main issue in the poorly differentitated cases, especially to the pathologists of Korea, an endemic area of hepatocellular carcinoma. Until now the problem has been usually solved by the comparison of cytologic characteristics of their tumor cells but not by background cytologic features which rarely have been studied. We observed the background cytologic features helpful for the differential diagnosis through the analysis of 20 cases who had confirmed primary cancer and were diagnosed as metastatic carcinomas in the liver by fine needle aspiration cytology. Twenty cases included 9 adenocarcinomas, 7 spuamous cell carcinomas, 1 small cell carcinoma, 1 carcinoid, 1 adenoid cystic carcinoma, and 1 renal cell cacinoma. Analysis of background cytologic features revealed that 77% of adenocacinoma cases showed benign mesenchymal components and hepatocytes and spuamous cell carcinoma cases disclosed benign mesenchymal tissue (71%) and necrosis (57%), Remaining cases showed variable combinations of benign mesenchymal component, necrosis, hepatocytes, and bile duct epithelial cells. No case revealed atypical hepatocytic naked nuclei, a useful cytologic finding of hepatocellular carcinoma. In summary, the background cytologic features more commonly observed in metastatic carcinomas than in the hepatocellular carcinoma were benign mesenchymal components, hepatocytes, necrosis, and bile duct epithelium. The endothelial cells and hepatocytic naked nuclei, two relatively specific findings of hepatocellular carcinoma were not observed except for renal ceil carcinoma. Above background cytologic features are thought to be helpful for the differential diagnosis between the hepatocellular carcinoma and various metastatic carcinomas in the poorly differentiated cases.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.247-257
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• 1992

Bronchial adenoma, firstly described by Muller[1882] had been reported on the subject stressed their benign nature prior to 1940`s, but these tumors including carcinoid tumor, mucoepidermoid carcinoma, adenoid cystic carcinoma, pleomorphic adenoma are now known to possess the various degree of malignant natures from benign course, low grade malignant potential to distant lymphatic or hematogenous metastasis or combination. Although histologically diffeerent, four varieties except carcinoid tumor which is a spectrum of neu-roendocrine tumor originating Kulchitsky cell of the bronchial epithelium and form the part of the APUD tumor spectrum, are morphologically and in many respects clinically similar to the corresponding tumor of the salivary gland is a specific varient of adenocarcinoma that occurs most commonly in the major and minor salivary gland and less frequently tra-cheobronchial tree, esophagus etc. To better understand the clinical characteristics and assess more precisely the malignat nature of bronchial adenoma, we studied 17 cases of bronchial adenoma, which had been experienced at the Department of Thoracic and Cardiovascular surgery of Catholic University Medical College from April 1977 to september 1991. Seventeen cases of bronchial adenoma consist of 2 carcinoid tumors, 6 adenoid cystic carcinomas, 8 mucoepidermoid carcinomas and one pleomorphic adenoma. There is a slight predominace of male patients[10/17] and the age of pt studied varied with a higher incidence occurring between the ages of 40 years and 60 years[mean age, 46.5 years]; the youngest being 15 years and oldest 69 years. Their leading complaints were hemoptysis[4], exertional dyspnea[8], fever & chilness [4], and symptoms mimicking the bronchial asthma[4]. Diagnosis was aided by the radiologic studies such as chest X-ray, polytomography, CT scan, brochography and bronchoscopy. The preferred locations of fumor were in the trachea[4], main stem bronchus[3], bronchus intermedius[3], bronchus of RUL[2], LUL[1], RLL[1], LLL[3] with no peripheral location. Modalities of treatments were single or combination of surgical resection, radiation therapy, chemotherapy. Complete resections were permitted in 12 cases with late recurrences of 4 cases ranging from 6 months to 10 years: pneumonectomy[4], lobectomy[4], bil-obectomy[2], sleeve resection[2]. Gross findings of resected specimens in 14 cases showed that 4 cases were polyp-like pedunculated mass[entirely intraluminal mass] with intact mucosa, 8 cases were broad-bas-ed sessile mass[predominatly intraluminal] and the main portions were located below the mucosa similar to tip of iceburg[predominantly extraluminal] in 2 cases. Follow-up information was availble in all 17 cases ; eight were alive without evidence of disese ranging from 1 month to 13 years. But seven cases died of the causes related to tumor[6 cases within 12 months, one case 10 years after pneumonectomy]. We concluded that 8 cases[47%] of 17 cases were metastasizing bronchial adenoma and precise survival rate cannot be answered by the scanty materials available for study.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.76-80
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• 2005

Although primary neuroendocrine carcinomas(NEC) are uncommon tumors of the larynx, they represent the most common nonepidermoid malignancy of this organ. Whereas typical carcinoid tumors and small-cell carcinomas occur very rarely in the larynx, the majority of laryngeal NEC belong to a broad intermediate group between these two extremes of NEC. Through many case studies, a major protion of clinicopathologic characteristics of laryngeal NEC have been revealed; however, the gistogenesis of laryngeal NEC is still unknown. The only well-documented normal neuroendocrine structures of the larynx are paraganglions, but the incidence of laryngeal paragangliomas are much lower than that of NEC. Here, we report on three cases of NEC affecting the larynx and the results of searching for neuroendocriene cells in non-neoplastic larynx tissue.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7835-7838
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• 2014

Background: Neuroendocrine tumors have widespread and different clinical presentations and prognoses. This study was conducted to assess their survival time and prognostic factors in Iran. Materials and Methods: In a retrospective cohort study, 189 patients diagnosed of having neuroendocrine carcinoma were chosen. The tumor and clinical characteristics of the patients were modeled with a Cox proportional hazard approach. Survival was assessed using Kaplan-Meyer curves. Results: Crude median survival time was 30 months. Women survived longer than men (the median survival time for women was 40 and for men was 24 months). Age (<60 vs >60 years old with hazard ratio (HR) of 2.43, 95% CI 1.3-4.5), primary pathology report (carcinoid vs. others with HR 5.85 cm, 95% CI 2.4-14.3), tumor size cm (for 5-10, HR of 3.1, 95% CI 1.6 and for >10 HR of 8.2, 95% with 95% CI 3.1-21.9), and chemotherapy with single drug (taking vs. not taking with a HR 2.2, 95% CI 1.1-4.8) had significant effects on overall survival of patients. Conclusions: Survival time in patients with neuroendocrine carcinomas is related to demographics, clinical characteristics, tumor histology, and subtype specific treatment.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.68-73
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• 2008

Background: The presence of infiltrated mediastinal lymph nodes is a crucial factor for the prognosis of lung cancer. The aim of our study is to investigate the pattern of metastatic non-small cell lung cancer that spreads to the mediastinal lymph nodes, in relation to the primary tumor site, in patients who underwent major lung resection with complete mediastinal lymph node dissection. Material and Method: We retrospectively. studies 293 consecutive patients [mean age $63.0{\pm}8.3$ years (range $37{\sim}88$) and 220 males (75.1%)] who underwent major lung resection due to non-small cell lung cancer from January 1998 to December 2005. The primary tumor and lymph node status was classified according to the international TNM staging system reported by Mountain. The histologic type of the tumors was determined according to the WHO classification. Fisher's exact test was used; otherwise the chi-square test of independence was employed. A p-value < 0.05 was considered significant. Result: Lobectomy was carried out in 180 patients, bilobectomy in 50, sleeve lobectomy in 10 and pnemonectomy in 53. The pathologic report revealed 124 adenocarcinomas, 138 squamous-cell tumors, 14 adenosquamous tumors, 1 carcinoid tumor, 8 large cell carcinomas, 1 carcinosarcoma, 2 mucoepidermoid carcinomas and 5 undifferentiated tumors. The TNM stage was IA in 51 patients, IB in 98, IIB in 41, IIIA in 71, IIIB in 61 and IV in 6. 25.9 % of the 79 patients had N2 tumor. Most common infiltrated mediastinal lymph node was level No.4 in the right upper lobe, level No. 4 and 5 in the left upper lobe and level No. 7 in the other lobes, but no statistically significant difference was observed. Thirty-six patients (12.3%) presented with skip metastasis to the mediastinum. Conclusion: Mediastinal lymph node dissection is necessary for accurately determining the pTNM stage. It seems that there is no definite way that non-small cell lung cancer spreads to the lymphatics, in relation to the location of the primary cancer. Further, skip metastasis to the mediastinal lymph nodes was present in 12.3% of our patients.