• 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.

• Journal of Gastric Cancer
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• v.19 no.1
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• pp.121-131
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• 2019

Purpose: The significance of neuroendocrine differentiation (NED) in gastric carcinoma (GC) is controversial, leading to ambiguous concepts in traditional classifications. This study aimed to determine the prognostic threshold of meaningful NED in GC and clarify its unclear features in existing classifications. Materials and Methods: Immunohistochemical staining for synaptophysin, chromogranin A, and neural cell adhesion molecule was performed for 945 GC specimens. Survival analysis was performed using the log-rank test and univariate/multivariate models with percentages of NED ($P_{NED}$) and demographic and clinicopathological parameters. Results: In total, 275 (29.1%) cases were immunoreactive to at least 1 neuroendocrine (NE) marker. GC-NED was more common in the upper third of the stomach. $P_{NED}$, and Borrmann's classification and tumor, lymph node, metastasis stages were independent prognostic factors. The cutoff $P_{NED}$ was 10%, beyond which patients had significantly worse outcomes, although the risk did not increase with higher $P_{NED}$. Tumors with ${\geq}10%$ NED tended to manifest as Borrmann type III lesion with mixed/diffuse morphology and poorer histological differentiation; the NE components in this population mainly grew in insulae/nests, which differed from the predominant growth pattern (glandular/acinar) in GC with <10% NED. Conclusions: GC with ${\geq}10%$ NED should be classified as a distinct subtype because of its worse prognosis, and more attention should be paid to the necessity of additional therapeutics for NE components.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.440-448
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• 1996

Bronchial carcinoid tumors are uncommon, constituting approximately 3-5% of all primary lung cancers. Classification of these tumors has evolved substantially as our understanding of the cellular, biologic, and clinical aspects of these neoplasms has improved. Initially, bronchial carcinoids were thought to be benign and therefore were classified as bronchial adenomas. Currently, however, they are well recognized as having the potential for both local invasion and distant metastatic involvement. Consequently, carcinoid tumors are frankly malignant. Thus bronchial adenoma is a misnomer that should no longer be used for bronchial carcinoids. Most investigators currently favor classifying carcinoid tumors as a type of neuroendocrine neoplasm because of their potential to secrete a variety of chemical substances found in both the central nervous system and the epithelial cells of numerous organs. Bronchial carcinoids are usually characterized by a slow growth pattern and a low incidence of metastasis, and histologically conformed by the azurophil staining and the presence of the characteristic neurosecretary granule on electron microscopy. Atypical carcinoid tumor was first defined by Arrigoni et al, who proposed the following criteria for separation of atypical carcinoid from typical carcinoid tumor : 1) increased mitotic activity with 1 mitotic figure per 1-2 high power fields(or 5-10 mitoses /10 HPF), 2) nuclear pleomorphism, hyperchromatism, and an abnormal nuclear-cytoplasmic ratio, 3) areas of increased cellularity with disorganization of the architecture, and 4) tumor necrosis. In contrast, typical carcinoid tumor may have focal cytologic pleomorphism, but necrosis is absent and mitotic figures are rare. Recently we experienced a case of atypical bronchial carcinoid with multiple distant metastasis, so we report this case with a review of 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.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.419-422
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• 2013

Conventional classifications of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) are rather unsatisfactory because of the variation in survival within each subgroup. Molecular markers are being found able to predict patient outcome in more and more tumours. The aim of this study was to characterize the expression of the proteins cyclin D1, cyclin E and P53 in GEP-NETs and assess any prognostic impact. Tumor specimens from 68 patients with a complete follow-up were studied immunohistochemically for cyclin D1, cyclin E and P53 expression. High cyclin D1 and cyclin E immunostaining (${\geq}$ 5% positive nuclei) was found in 48 (71%) and 24 (35%) cases, and high P53 staining (${\geq}$ 10% positive nuclei) in 33 (49%). High expression of P53 was more common in gastric neuroendocrine tumors and related to malignant behavior, being associate with a worse prognosis on univariate analysis (RR=1.9, 95%CI=1.1-3.2). High expression of cyclin E was significantly associated with shorter survival in the univariate analysis (RR=2.0, 95%CI=1.2-3.6) and multivariate analysis (RR=2.1, 95%CI=1.1-4.0). We found no significant correlation between the expression of cyclin D1 and any clinicopathological variables. Our study indicated a prognostic relevance for cyclin E and P53 immunoreactivity. Cyclin E may be an independent prognostic factor from the 2010 WHO Classification which should be evaluated in further studies.

• Tuberculosis and Respiratory Diseases
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• v.50 no.5
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• pp.641-644
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• 2001

Pulmonary blastoma is a family of tumors in which the glands or mesenchyme composing the neoplasm are primitive or embryonic in appearance. There are three subtypes, which include well differentiated fetal adenocarcinoma (pulmonary endodermal tumor), biphasic pulmonary blastoma, and cystic and pleuropulmonary blastomas in children. Among them, biphasic pulmonary blastoma is a primary malignancy of the lung originating from multipotential pulmonary blastema including both the malignant fetal epithelial and mesenchymal components. These make up 0.25 to 0.5 percent of all primary malignant lung tumors. This tumor is usually symptomatic and appears as a large, solitary peripheral mass, with a tendency to favor the upper lobe. Here we report a case where a small sized asymptomatic peripheral lung mass was diagnosed as a biphasic pulmonary blastoma, prior to the operation, A subsequent percutaneous needle biopsy was performed, which revealed features of a large cell neuroendocrine tumor. In addition, a review of the relevant literature is provided.

• Journal of Yeungnam Medical Science
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• v.27 no.2
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• pp.98-104
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• 2010

Primary anterior mediastinal neoplasms comprise a diverse group of tumors and account for 50% of all mediastinal masses. Thymic epithelial neoplasm are most common and classified into thymoma, invasive thymoma, and thymic carcinoma. Neuroendocrine differentiation of thymic epithelial neoplasm are rare malignancies. Germ cell tumor (GCT) is second most common anterior mediastinal tumor and most of them are mature cystic teratoma. Malignant mediastinal GCT are rare than benign. Primary thoracic lymphoma is rare than thoracic involvement of systemic lymphoma and most common location of primary thoracic lymphoma is anterior mediastinum. The clinical and radiologic appearance of the most common masses are reviewed.