• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.205-209
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• 2018

Merkel cell carcinoma (MCC) is an uncommon neuroendocrine cutaneous tumor with poor prognosis. It has the high rate of recurrence, mortality, regional nodal involvement, and distant metastases. It is difficult to diagnose MCC because of its non-specific clinical findings. It usually occurs on sun-exposed areas of the skin, mostly at head and neck. There is a difference in the incidence and prognosis according to site in the head and neck. However, there is no consented site-specific diagnosis, treatment or follow-up protocol for MCC at the head and neck. We herein report a case of MCC arising in the right earlobe of an otherwise healthy young man who has been diagnosed early, thereby successfully treated. With our closed follow-up, there was no tumor recurrence or complication at 33 months after diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4537-4540
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• 2012

Background: The pancreatic neuroendocrine tumor (pNET) is relatively rare and generally felt to follow an indolent course. EUS has an important role in detection of pNET. This is a review of clinical and radiological presentation and pathologic reports of 22 patients with pNET. Patients and methods: In this study we analyzed clinical and radiological presentations and pathologic reports of all relevant cases who were referred to Taleghani hospital for 3 years since 2008. Results: A total of 22 patients 28-74 years old (mean=49) were enrolled between 2008 and 2011. Among the total, 13 (59%) were male, 9 (41%) were female and 16 (72.7%) had functional tumors. The results of CT were negative in 12 (54%) cases but EUS was capable of detecting the lesions in these patients, cysts being found in 4 (19%) patients. Conclusion: EUS is a highly sensitive procedure for the localization of functional pNETs and especially insulinomas. Nonfunctional tumors were detected in more advanced and late stages and cystic lesions were more common in this group.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2541-2546
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• 2014

Background: Primary hepatic neuroendocrine carcinoma (PHNEC) is rarer than extrahepatic gastrointestinal neuroendocrine carcinoma (NEC). It is difficult to make a correct diagnosis and poses a challenge for management. Materials and Methods: Ten PHNEC patients were admitted to our hospital from June 2006 to June 2011. Laboratory tests and imaging scans were performed for diagnosis and exclusion of extrahepatic NEC. All patients were AFP - and CA199-. Seven patients had solid tumors with cystic changes on ultrasonography, CT and/or MRI. For the initial treatment, four patients received combined-therapy and six monotherapy. Considering overall treatment, six patients received combined-therapy and four patients monotherapy. Staging criteria of primary hepatocellular carcinoma (PHC, AJCC 7th edition) were used to differentiate the stage of all patients: 3 patients were stage I, 2 stageII, 4 patients stageIII and 1 stageIV. All patients were followed up and clinical data were gathered. Results: The median follow-up duration was 38.5 months. The 1-year, 2-year, 3-year and 6-year disease-free survival was 80.0%, 46.2% and 46.2% and 0% respectively. The overall survival rates were 100%, 67.1%, 67.1% and 33.6% respectively. Patients in early-stages (I/II) had similar disease-free and overall survival as those in advanced-stages (III/IV). Patients with monotherapy had significant shorter disease-free and overall survival than the patients with combination-therapy. Conclusions: PHNEC has a unique specificity during its occurrence and development. The staging criteria of PHC might not be suitable for the PHENT. More convenient and effective features need to be found in imaging and laboratory detection. Surgical resection, TACE, chemotherapy and radiofrequency ablation should be performed in combination and actively for patients with PHNEC or recurrence to get the best effectiveness; they might extend the disease-free and overall survival.

• Korean Journal of Radiology
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• v.19 no.6
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• pp.1066-1076
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• 2018

Objective: The reliability of size measurements of liver metastases from neuroendocrine tumors (NETs) on contrast-enhanced computed tomography (CT) phases made by different readers may be hampered due to transient, variable rim enhancement in arterial phase (AP) or portal venous phase (PVP) images. We aimed to assess the reliability of tumor size measurements in pre- and post-contrast scans. Materials and Methods: The study coordinator selected target lesions according to Response Evaluation Criteria in Solid Tumors 1.1 guidelines in 44 consecutive patients with pathologically confirmed NET liver metastases. Two blinded readers measured the longest diameters of target lesions on pre-contrast, AP, and PVP images twice with a 4-week interval. Inter- and intra-observer agreements were evaluated using Bland-Altman plots and 95% limit of agreement (LOA) calculations. Results: Of the 79 target lesions (approximate mean size of 3 cm), 45 showed rim enhancement. Inter-observer agreement assessed based on LOA was highest in pre-contrast CT images (-6.1-5.7 mm), followed by PVP (-7.9-7.1 mm) and AP (-8.5-7.4 mm) images. Intra-observer agreement showed the same trend: -2.8-2.9 mm and -2.9-2.9 mm for readers 1 and 2, respectively, on pre-contrast CT, -2.8-2.9 mm and -3.0-3.2 mm, respectively, on PVP, and -3.2-4.2 mm and -3.4-3.2 mm, respectively, on AP images. Mean tumor diameters differed significantly among the phases in the following increasing order: pre-contrast CT, PVP, and AP images. Conclusion: There was better inter- and intra-observer agreement in size measurements of NET liver metastases on pre-contrast scans than on AP and PVP scans. Pre-contrast CT may be the optimal for measuring NET liver metastases if its accuracy is proven.

• The Korean Journal of Cytopathology
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• v.3 no.2
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• pp.37-51
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• 1992

The fine needle aspiration (FNA) cytology findings in 19 cases of primary neoplasia of the pancreas are reported. The aspirates were obtained under ultrasound guidance in 16 cases and under direct vision intraoperatively in three cases. These cases represented 79% of 24 diagnoses in a series of 30 pancreatic FNAs. Of these 30 cases no cytologic diagnoses were made in six cases (20%) because of insufficient or inadequate samples The cytologic diagnoses were confirmed by histologic examination following resection or biopsy of the tumors. The diagnoses included 9 duct ceil adenocarcinomas, 1 mucinous adenocarcinoma, 2 mucinous cystadenocarcinomas, 1 acinar cell carcinoma, 1 papillary cystic tumor 3 islet ceil tumors, 1 neuroendocrine carcinoma and 1 leiomyosarcoma. The cytologic features of the neoplasia were detailed and the differential diagnosis was discussed. The important criteria for the cytodiagnosis of pancreatic tumors were reviewed. This review leads us to think that nonoperative (percutaneous) cytologic approaches to the diagnosis of pancreatic tumor are advantageous for the management of patients, and that correct cytologic diagnosis with pancreatic FNAs can easily be made, if adequate samples are obtained.

• Investigative Magnetic Resonance Imaging
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• v.11 no.2
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• pp.127-132
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• 2007

Sinonasal neuroendocrine carcinoma is a rare disease, and reports focusing on the MR imaging findings of sinonasal neuroendocrine carcinoma are extremely rare. Threrefore we intend to report 2 cases of histologically confirmed neuroendocrine carcinoma. A 62-year-old man and a 74-year-old man are both presented with nasal bleeding. Computed tomography(CT) images of the 2 patients showed large, ill-defined masses in sinonasal cavities with adjacent bony destructions. MR images showed masses with isosignal intensity on Tl-weighted images and mixed iso- and high signal intensity on T2-weighted images. Post-contrast MR images showed heterogenous enhancement of masses with necrosis. Adjacent bony destructions were also noted on MR images. In both cases, peritumoral cystic lesions or mucoceles with high signal intensity on T1-weighted images were noted in sphenoid sinus. Both of the CT and MR imaging findings of the 2 patients were nonspecific which are usually seen in malignant tumor. But further study is needed for the significance of the peritumoral cystic areas adjacent the tumors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6679-6683
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• 2014

Background: Carcinoid crisis is a life-threating syndrome of neuroendocrine tumors (NETs) characterized by dramatic blood pressure fluctuation, arrhythmias, and bronchospasm. In the era of booming anti-tumor therapeutics, this has become more important since associated stresses can trigger carcinoid crisis. Somatostatin analogues (SSTA) have been recommended for prophylactic administration before intervention procedures for functioning NETs. However, the efficacy is still controversial. The aim of this article is to review efficacy of SSTA for preventing carcinoid crisis. Materials and Methods: PubMed, Cochrane Controlled trials Register, and EMBASE were searched using 'carcinoid crisis' as a search term combining terms with 'somatostatin'; 'octreotide'; 'lanreotide' and 'pasireotide' until December 2013. Results: Twenty-eight articles were retrieved with a total of fifty-three unique patients identified for carcinoid crisis. The most common primary sites of NETs were the small intestine and respiratory tract. The triggering factors for carcinoid crisis included anesthesia/surgery (63.5%), interventional therapy (11.5%), radionuclide therapy (9.6%), examination (7.7%), medication (3.8%), biopsy (2%) and spontaneous (2%). No randomized controlled trials (RCTs) were identified and two case-control studies were included to assess the efficacy of SSTA for preventing carcinoid crisis by meta-analysis. The overall pooled risk of perioperative carcinoid crisis was similar despite the prophylactic administration of SSTA (OR 0.44, 95% CI: 0.14 to 1.35, p=0.15). Conclusions: SSTA wasnot helpful for preventing carcinoid crisis based on a meta-analysis of retrospective studies. Attentive monitoring and careful intervention are essential. Future studies with better quality are needed to clarify any effect of SSTA for preventing carcinoid crisis.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.3 no.2
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• pp.85-90
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• 2017

$^{68}Ga-PET$ is of growing importance in the practice of nuclear medicine diagnostic imaging for neuroendocrine tumors as well as prostate cancers. Following this interests, we herein present the radiosynthesis process of [$^{68}Ga$]edotreotide ([$^{68}Ga$]DOTA-TOC) based on the fully automated procedure for clinical doses that can be provided the reduction of radiation exposure and high reproducibility. The quality controls of clinical doses in compliant with European Pharmacopoeia are also discussed.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.623-629
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• 1996

Bronchial carcinoid tumors are uncommon, constituting approximately 5% of all primary lung cancers. Carcinoid tumors belong to the calss of neuroendocrine tumors that consist of cells that can store and secrete neuramines and neuropeptides. Neuroendocrine tumors of the lung include three pathologic types : a low-grade malignancy, the so-called 'typical carcinoid', a more aggressive tumor, the "atypical carcinoid", and the most aggressive malignant neoplasm, the small-cell carcinoma. Atypical carcinoid tumor have a higher malignant potential, is more commonly peripheral than is the typical carcinoid tumor. Histologic features would characterize a carcinoid as hitologically atypical : increased mitotic activity, pleomorphism and irregularity of neuclei with promonent nucleoli, hyperchromatin, and abnormal nuclear-cytoplasmic ratio, areas of increased cellularity with disorganization of architecture, and areas of tumor necrosis. Metastatic involvement of regional lymph nodes and distant organ is common. The prognosis is related to size of the tumor, typical of atypical appearance, endoluminal of extraluminal growth, vascular invasion, node metastasis, Pulmonary resection is the treatement of choice for bronchial carcinoid. We experienced one case of bronchopulmonary atypical carcinoid tumor. In the case, radiologic study showed solitary lung mass with liver metastasis and the level of 5-HIAA was elevated. There was no history of cutaneous flushing, diarrhea, valvular heart disease. The authors reported a case of bronchopulmonary atypical carcinoid tumor with review of literatures.

• Journal of Digestive Cancer Research
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• v.5 no.2
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• pp.86-90
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• 2017

Background: The aim of this study was to investigate clinicopathologic features of type 3 gastric neuroendocrine neoplasm (NEN) by treatment modality. Methods: The Korean Society of Gastrointestinal Cancer conducted the Korean Gastroenteropancreatic Neuroendocrine Tumor Registry, a retrospective registry database of gastroenteropancreatic neuroendocrine tumors from 16 hospitals in Korea. The normal serum gastrin level range was defined as <100 pg/mL, and gastric NEN patients with normal gastrin level were selected for analysis. Results: Among 358 patients with gastric NEN, 21 (5.9%) patients were classified with type 3 gastric NEN. The median age was 53 years (range 30-74). According to the WHO 2010 classification, 13 (61.9%) patients had grade 1, and 8 (38.1%) patients had grade 2 or 3. Endoscopic treatment was performed in 14 (66.7%) patients, and surgery was performed in 7 (33.3%) patients. The tumor size was smaller in the endoscopic treatment group than in the surgery group (0.6 cm vs 1.3 cm, p=0.006). After treatment, there was one recurrence in the surgery group. Conclusion: In small size Type 3 gastric NEN, endoscopic treatment was associated with a good prognosis, compared to surgery. Thus, endoscopic treatment can be used an alternative modality in selected cases of type 3 gastric NEN.