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PubMed - Carcinoid (81 unread)

New images in carcinoid heart disease.

Fetched: May 24th, 2012, 11:00pm MDT

New images in carcinoid heart disease.

Cardiovasc J Afr. 2012 May;23(4):e8-e10

Authors: Klobučić M, Paar MH, Padovan RS, Vincelj J, Fila B

Abstract
Echocardiography was the main imaging technique in the diagnosis and follow up of carcinoid heart disease but in the last decade magnetic resonance imaging (MRI) has evolved into a new diagnostic modality. Most of the reported MRI features were similar to those observed by echocardiography - tricuspid and/or pulmonary valve thickening and immobility with consequent valvular dysfunction and right heart enlargement. To our knowledge, this is the first report describing endocardial enhancement of the right cardiac chambers, tricuspid valve and subvalvular apparatus, which corresponds with histologically seen fibrous carcinoid plaques.

PMID: 22614703 [PubMed - in process]

Neuroendocrine Tumors of the Submandibular Gland: Literature Review and Report of a Case.

Fetched: May 24th, 2012, 11:00pm MDT

Neuroendocrine Tumors of the Submandibular Gland: Literature Review and Report of a Case.

Int J Surg Pathol. 2012 May 21;

Authors: Petrone G, Santoro A, Angrisani B, Novello M, Scarano E, Rindi G, Lauriola L

Abstract
Primary salivary neuroendocrine neoplasms are extremely rare, with only 1 case of carcinoid tumor and 7 cases of primary large-cell neuroendocrine carcinomas having been reported. Salivary small-cell neuroendocrine carcinomas are more frequent, accounting for less than 2% of all salivary malignancies. In addition to a literature review on the subject, the authors describe a rare case of malignant intermediate-grade neuroendocrine tumor of the submandibular gland.

PMID: 22614165 [PubMed - as supplied by publisher]

Intrathoracic migration of a silicone breast implant 5 months after video-assisted thoracoscopic surgery.

Fetched: May 19th, 2012, 11:00pm MDT

Intrathoracic migration of a silicone breast implant 5 months after video-assisted thoracoscopic surgery.

J Comput Assist Tomogr. 2012 May;36(3):306-7

Authors: Sykes JB, Rosella PA

Abstract
ABSTRACT: A 72-year-old woman, who had previous bilateral reconstruction mammoplasty, underwent video-assisted thoracoscopic surgery for a right middle lobe pulmonary carcinoid. Five months after her surgery, the patient noticed an acute pronounced reduction in her right breast volume, with shortness of breath and cough. A computed tomography study of the chest revealed intrathoracic migration and rupture of her right breast implant, with associated silicone thorax. Subsequent video-assisted thoracoscopic surgery confirmed this diagnosis.

PMID: 22592613 [PubMed - in process]

Gastroenteropancreatic Neuroendocrine Tumors: Update on Therapeutics (June).

Fetched: May 19th, 2012, 11:00pm MDT

Gastroenteropancreatic Neuroendocrine Tumors: Update on Therapeutics (June).

Ann Pharmacother. 2012 May 15;

Authors: Ganetsky A, Bhatt V

Abstract
OBJECTIVE:To review the available literature addressing the treatment of pancreatic neuroendocrine tumors (PNETs) and carcinoid tumors.DATA SOURCES:Relevant literature was identified by a PubMed search (January 1977-December 2011) of English-language literature using the terms gastroenteropancreatic neuroendocrine tumor, pancreatic neuroendocrine, carcinoid, and pancreatic islet cell tumor.STUDY SELECTION AND DATA EXTRACTION:All published studies and abstracts, as well as relevant consensus guidelines, evaluating the current literature about PNETs and carcinoid tumors were included.DATA SYNTHESIS:Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a genetically diverse group of complex malignancies with varying biologicaland clinical courses. Historically believed to be rare, recent epidemiologic data suggest their incidence is rising. Two of the most commonly diagnosed GEPNETs are PNETs and carcinoid tumors. Both subtypes are well-differentiated tumors and present as low or intermediate grade. The systemic manifestations of PNETs and carcinoid tumors are diverse and are related to the secretion of affected hormones and biogenic amines. Surgical resection of localized disease remains the only curative option. However, the utility of this approach is limited because most patients are diagnosed with advanced disease. Recent advances have led to an improvement in outcomes in patients with PNETs and carcinoid tumors. This review describes traditional therapies as well as emerging strategies being investigated to help manage these cancers. Treatment of poorly differentiated GEP-NETs is beyond the scope of this review.CONCLUSIONS:The advent of new therapies for PNETs and carcinoid tumors has introduced a paradigm shift in the management of this heterogeneous malignancy.

PMID: 22589450 [PubMed - as supplied by publisher]

Permalink for 'Immunohistochemical Evaluation of Inhibin-alpha in Non-Small-Cell Lung Carcinomas - a Pitfall in Diagnosing Metastatic Pulmonary Carcinomas.'

Immunohistochemical Evaluation of Inhibin-alpha in Non-Small-Cell Lung Carcinomas - a Pitfall in Diagnosing Metastatic Pulmonary Carcinomas.

Fetched: May 19th, 2012, 11:00pm MDT

Immunohistochemical Evaluation of Inhibin-alpha in Non-Small-Cell Lung Carcinomas - a Pitfall in Diagnosing Metastatic Pulmonary Carcinomas.

Ann Clin Lab Sci. 2012;42(2):118-22

Authors: Zhang K, Shi J, Lin F

Abstract
Context Inhibin-alpha is commonly used in differentiating non-small-cell lung carcinoma from certain metastatic carcinomas, but a study on a large series of primary lung cancer cases has not yet been published. Objective To establish whether non-small-cell lung carcinoma can express inhibin-alpha; if so, caution should be exercised when using the molecule to evaluate metastatic lung cancer in both lung and extrapulmonary sites. Design 187 cases of non-small-cell lung carcinoma and small-cell lung carcinoma were evaluated for expression of inhibin-alpha on both routine and tissue microarray sections by immunohistochemistry. These cases included 90 mixed or acinar adenocarcinomas, 2 acinar carcinomas with mucinous feature, 6 bronchioloalveolar carcinomas, 9 large-cell carcinomas, 2 adenosquamous carcinomas, 2 sarcomatoid carcinomas, 41 squamous cell carcinomas, 12 typical carcinoid tumors, 3 atypical carcinoid tumors, 20 small-cell lung carcinomas, and 19 cases of normal lung. The staining intensity was graded as weak, intermediate, or strong. The distribution was recorded as negative (no staining), 1+ (<25%), 2+ (26-50%), 3+ (51-75%), or 4+ (>75%). Cytoplasmic coarse granular staining for inhibin-alpha was the indicator for a positive result. Results A subset of primary mixed or acinar and mucin-producing acinar carcinomas (10%) and large-cell carcinomas (22%) expressed inhibin-alpha. No expression of inhibin alpha was observed in the remaining cancers or normal lung samples. Conclusion Since a significant percentage of non-small-cell lung carcinoma cases expressed inhibin-alpha, caution should be taken when using inhibinalpha as the key antibody for exclusion of a lung primary in lung and other organs.

PMID: 22585605 [PubMed - in process]

Mesenteric carcinoid.

Fetched: May 19th, 2012, 11:00pm MDT

Mesenteric carcinoid.

Indian J Gastroenterol. 2012 May 16;

Authors: Udare AS, Mondel PK, Raut A, Hira P

PMID: 22585568 [PubMed - as supplied by publisher]

64-section multiphase CT enterography as a diagnostic tool in the evaluation of obscure gastrointestinal bleeding.

Fetched: May 19th, 2012, 11:00pm MDT

64-section multiphase CT enterography as a diagnostic tool in the evaluation of obscure gastrointestinal bleeding.

Indian J Gastroenterol. 2012 May 15;

Authors: Sodhi JS, Zargar SA, Rashid W, Shaheen F, Singh M, Javid G, Ali S, Khan BA, Yattoo GN, Shah A, Gulzar GM, Khan MA, Ahmad Z

Abstract
BACKGROUND AND AIM: Small bowel follow through (SBFT) and enteroclysis have low sensitivity in picking up lesions in obscure gastrointestinal bleed (OGIB). Computed tomographic enterography (CT-EG), performed with 64-slice multiphase CT system by using large volumes of ingested neutral enteric contrast material, has high spatial and temporal resolution in visualization of the small bowel wall and lumen. The role of 64-slice multiphase CT-EG in the evaluation of OGIB is still evolving, and data on this role are scarce. We evaluated the efficacy of 64-slice multiphase CT-EG using polyethylene glycol (PEG) electrolyte solution as neutral contrast in patients of OGIB. METHODS: CT-EG was performed with 64-slice multiphase CT system using large volume (2,000 mL) of PEG electrolyte solution as oral contrast in patients of OGIB. RESULTS: Thirty-five patients (21 men, age 41.4 [13.5] y, range 19-70 year) with OGIB underwent CT-EG; 20 patients had overt OGIB whereas 15 patients had occult OGIB. Among 15 patients with occult OGIB, 10 patients had iron deficiency anemia (IDA) with fecal occult blood test (FOBT) positive and 5 had IDA with FOBT negative. Thirty-two patients (92 %) completed the procedure successfully. The total time taken for the ingestion of 2,000 mL of PEG electrolyte solution was median 64 (range 60-78) minutes. Adequate luminal distension of small bowel was seen in 29 (90.6 %) patients for successful interpretation of radiological images. Fifteen of 32 (46.9 %) patients had positive findings on CT-EG; 12 of them underwent exploratory laparotomy. The surgical findings were in conformity with CT-EG findings in all patients, which included gastrointestinal stromal tumors (GIST; n = 6), carcinoid (1), Meckel's diverticulum (1), small bowel adenocarcinoma (2) and jejunal vascular malformation (2). CONCLUSION: 64-slice multiphase CT-EG is a useful investigation in the evaluation of both occult and overt OGIB.

PMID: 22585567 [PubMed - as supplied by publisher]

Endoscopic and pathological aspects of gastric polyps: a Turkish referral center study.

Fetched: May 19th, 2012, 11:00pm MDT

Endoscopic and pathological aspects of gastric polyps: a Turkish referral center study.

Hepatogastroenterology. 2012 Jul-Aug;59(116):1147-9

Authors: Kekilli M, Beyazit Y, Karaman K, Sayilir A, Kurt M, Onal IK, Yesil Y, Akdogan M, Sasmaz N

Abstract
Background/Aims: The aim of the present study was to retrospectively analyze all the polyps of patients undergoing endoscopic polypectomy or forceps biopsy according to their types, frequency, localization, number and gender distribution. Methodology: Data from patients who underwent upper endoscopy in the Türkiye Yüksek Ihtisas Postgraduate Research Hospital between March 2007 and November 2009 were analyzed retrospectively. Forceps biopsy or polypectomy were performed for all polypoid lesions that were identified during the endoscopy. Results: In the study period, 14,935 patients underwent 18,522 upper endoscopies. After excluding cirrhotic patients, and patients with a history of prior gastrectomy, chronic gastritis and edema or congestion, the remaining 124 (0.83%) patients with gastric polyps were included in the study. Histopathologically, the most frequently diagnosed polyps were hyperplastic polyps (55.6%). Fundic gland polyps (9.7%), foveolar hyperplasia (8.1%) and inflammatory polyps (7.3%) were also frequent. Adenocarcinoma was more frequently seen in males, whereas hyperplastic polyps and carcinoid tumors were found more often in females, and this difference was statistically significant (p<0.009). Conclusions: Results of the present study indicate that hyperplastic polyps make up the largest group. Although there is widespread PPI use, no increases in the frequency of fundic gland polyps were observed. However, increases in the ratio of carcinoid tumors suggest a suspicion of tumor development with PPI use.

PMID: 22580668 [PubMed - in process]

Molecular and Cellular Biology of Neuroendocrine Lung Tumors: Evidence for Separate Biological Entities.

Fetched: May 19th, 2012, 11:00pm MDT

Molecular and Cellular Biology of Neuroendocrine Lung Tumors: Evidence for Separate Biological Entities.

Biochim Biophys Acta. 2012 May 10;

Authors: Swarts DR, Ramaekers FC, Speel EJ

Abstract
Pulmonary neuroendocrine tumors (NETs) are traditionally described as comprising a spectrum of neoplasms, ranging from low grade typical carcinoids (TCs) via the intermediate grade atypical carcinoids (ACs) to the highly malignant small cell lung cancers (SCLCs) and large cell neuroendocrine carcinomas (LCNECs). Recent data, however, suggests that two categories can be distinguished on basis of molecular and clinical data, i.e. the high grade neuroendocrine (NE) carcinomas and the carcinoid tumors. Bronchial carcinoids and SCLCs may originate from the same pulmonary NE precursor cells, but a precursor lesion has only been observed in association with carcinoids, termed diffuse idiopathic pulmonary neuroendocrine cell hyperplasia. The occurrence of mixed tumors exclusively comprising of high grade NE carcinomas also supports a different carcinogenesis for these two groups. Histopathologically, high grade NE lung tumors are characterized by high mitotic and proliferative indices, while carcinoids are defined by maximally 10 mitoses per 2mm(2) (10 high-power fields) and rarely have Ki67-proliferative indices over 10%. High grade NE carcinomas are chemosensitive tumors, although they usually relapse. Surgery is often no option due to extensive disease at presentation and early metastasis, especially in SCLC. Conversely, carcinoids are often insensitive to chemo- and radiation therapy, but cure can usually be archieved by surgery. A meta-analysis of comparative genomic hybridization studies performed for this review, as well as gene expression profiling data indicate separate clustering of carcinoids and carcinomas. Chromosomal aberrations are much more frequent in carcinomas, except for deletion of 11q, which is involved in the whole spectrum of NE lung tumors. Deletions of chromosome 3p are rare in carcinoids but are a hallmark of the high grade pulmonary NE carcinomas. On the contrary, mutations of the multiple endocrine neoplasia type 1 (MEN1) gene are restricted to carcinoid tumors. Many of the differences between carcinoids and high grade lung NETs can be ascribed to tobacco consumption, which is strongly linked to the occurrence of high grade NE carcinomas. Smoking causes p53 mutations, very frequently present in SCLCs and LCNECs, but rarely in carcinoids. It further results in other early genetic events in SCLCs and LCNECs, such as 3p and 17p deletions. Smoking induces downregulation of E-cadherin and associated epithelial to mesenchymal transition. Also, high grade lung NETs display higher frequencies of aberrations of the Rb pathway, and of the intrinsic and extrinsic apoptotic routes. Carcinoid biology on the other hand is not depending on cigarette smoke intake but rather characterized by aberrations of other specific genetic events, probably including Menin or its targets and interaction partners. This results in a gradual evolution, most likely from proliferating pulmonary NE cells via hyperplasia and tumorlets towards classical carcinoid tumors. We conclude that carcinoids and high grade NE lung carcinomas are separate biological entities and do not comprise one spectrum of pulmonary NETs. This implies the need to reconsider both diagnostic as well as therapeutic approaches for these different groups of malignancies.

PMID: 22579738 [PubMed - as supplied by publisher]

Small bowel tumors: What is the contribution of video capsule endoscopy?

Fetched: May 19th, 2012, 11:00pm MDT

Small bowel tumors: What is the contribution of video capsule endoscopy?

Clin Res Hepatol Gastroenterol. 2012 May 11;

Authors: Achour J, Serraj I, Amrani L, Amrani N

Abstract
BACKGROUND: Intestinal tumors represent less than 6% of digestive tumors and, because of the limitations of intestinal investigations, these tumors are difficult to diagnose. In this context, capsule endoscopy (CE) has proven effective especially in patients with obscure digestive bleeding. The aim of the present study was to calculate the frequency, and evaluate the diagnostic and therapeutic impact of CE in cases of small bowel tumors. PATIENTS AND METHODS: A total of 95 patients (57 males and 38 females, mean age of 56 years) with negative endoscopy and colonoscopy results were directed to undergo CE examination. RESULTS: Of the 95 patients, 13 (13.7%) were diagnosed with small bowel tumors. The main indications for CE were obscure (occult and overt) gastrointestinal bleeding. The mean duration of symptoms before diagnosis was 10 months. The final histological diagnosis was established through surgery. In our patients, this included gastrointestinal stromal tumor (nine cases), adenocarcinoma (two cases) and carcinoid tumor (two cases). CONCLUSION: This study revealed that the prevalence of intestinal tumors appears to be higher than expected in patients through the use of CE.

PMID: 22579677 [PubMed - as supplied by publisher]

Education and imaging. Gastrointestinal: Duodenal tumour and cutaneous skin lesions.

Fetched: May 19th, 2012, 11:00pm MDT

Education and imaging. Gastrointestinal: Duodenal tumour and cutaneous skin lesions.

J Gastroenterol Hepatol. 2012 Feb;27(2):414

Authors: Nikfarjam M, Frias-Kletecka C, Hardacre J

PMID: 22260285 [PubMed - indexed for MEDLINE]

Permalink for 'Limited role of Ki-67 proliferative index in predicting overall short-term survival in patients with typical and atypical pulmonary carcinoid tumors.'

Limited role of Ki-67 proliferative index in predicting overall short-term survival in patients with typical and atypical pulmonary carcinoid tumors.

Fetched: May 13th, 2012, 11:00pm MDT

Limited role of Ki-67 proliferative index in predicting overall short-term survival in patients with typical and atypical pulmonary carcinoid tumors.

Mod Pathol. 2012 May 11;

Authors: Walts AE, Ines D, Marchevsky AM

Abstract
Pulmonary carcinoid tumors are currently classified as typical or atypical based on the mitotic index (2 per 10 hpf) and/or the presence of necrosis. Following incorporation of the Ki-67 index into the classification of GI carcinoid tumors, our oncologists have also been requesting this test as part of the work-up of pulmonary carcinoid tumors although there are currently no established criteria for interpreting Ki-67 index in these neoplasms. We utilized the Ariol(®) SL50 Image Analyzer system to measure the Ki-67 index in 101 pulmonary carcinoid tumors (78 typical and 23 atypical) and then correlated the Ki-67 index and the histological diagnoses in univariate and multivariable analysis with overall survival. The mean Ki-67 indices for the typical carcinoids (3.7 s.d.±4.0) and the atypical carcinoids (18.8 s.d.±17.1) were significantly different (P<0.001) although the frequency distributions of Ki-67 indices in the two groups overlapped considerably. Receiver operating characteristic curve analysis showed that a Ki-67 index cutoff value of 5% provided the best fit for specificity and sensitivity in predicting overall survival. Histological diagnosis and the Ki-67 index cutoff of 5% were each independently strong predictors of survival (P<0.001 and P=0.003, respectively). When considered together in multivariable analysis, histological diagnosis was the stronger predictor of overall survival and a Ki-67 index cutoff of 5% did not provide additional significant predictive survival information within either the typical carcinoid or the atypical carcinoid patient group. A few typical carcinoid patients with Ki-67 indices of 5% appeared to have worse survival after 5 years than those with Ki-67 indices <5%, but the data set was insufficiently powered to further analyze this. These findings do not provide best evidence for the routine use of Ki-67 index to prognosticate overall short-term survival in patients with pulmonary carcinoid tumors.Modern Pathology advance online publication, 11 May 2012; doi:10.1038/modpathol.2012.81.

PMID: 22575865 [PubMed - as supplied by publisher]

Recurrent Anaphylactic Reactions: An Uncommon Debut of Lymphocytic Hypophysitis.

Fetched: May 13th, 2012, 11:00pm MDT

Recurrent Anaphylactic Reactions: An Uncommon Debut of Lymphocytic Hypophysitis.

Int Arch Allergy Immunol. 2012 May 4;159(1):103-106

Authors: Bobolea I, Guillén D, Barranco P, Alvarez-Escola C, Quirce S

Abstract
We report on a 24-year-old male, with exercise-induced asthma and intermittent abdominal pain since puberty, who suffered from recurrent anaphylactic reactions. He also complained of occasional headaches. After extensive studies he was eventually diagnosed with idiopathic anaphylaxis, once the following diagnoses had been excluded: allergic origin [foods (including ω5-gliadin), latex and drugs], hydatidosis, carcinoid syndrome, systemic mastocytosis, autonomic epilepsy, hereditary angioedema, pheocromocitoma, Meckel diverticle, medullar thyroid carcinoma, leukemia, hyper-IgE and hypereosinophilic syndromes. Given the frequency and severity of the attacks, we started off-label treatment with omalizumab, initially well tolerated. Some days after the second dose the patient started to develop recurrent urticaria. Because of these new symptoms, blood work was repeated, and elevated TSH, decreased T4, positive antithyroid antibodies and decreased cortisol levels with normal ACTH were found. The antiadrenal autoantibodies were negative. The MRI showed a slight thickening of the infundibulum, without pituitary adenoma. Suspecting an autoimmune hypophysitis, we looked for antipituitary antibodies; the result was positive. A clinical picture of recurrent anaphylactic reactions, the result of complicated adrenal crises in an asthmatic patient, was a manifestation of lymphocytic hypophysitis, a rare chronic inflammatory disease of autoimmune etiology. One year after replacement therapy had been started, the patient remained asymptomatic.

PMID: 22573101 [PubMed - as supplied by publisher]

[A case of difficult ventilation during resection of an intratracheal carcinoid tumor].

Fetched: May 13th, 2012, 11:00pm MDT

[A case of difficult ventilation during resection of an intratracheal carcinoid tumor].

Masui. 2012 Mar;61(3):318-21

Authors: Nemoto C, Tsunoda A, Nakano Y, Akatsu M, Isosu T, Murakawa M

Abstract
There is difficulty in airway management during intratracheal operation. We experienced airway obstruction during resection of an intratracheal carcinoid tumor using YAG laser. A 65-year-old woman was diagnosed with an intratracheal carcinoid tumor. The intratracheal tumor existed closely to the vocal cords and the middle of the trachea. Preoperative examinations of the blood gas and respiratory functions were normal. Under general anesthesia, LMA was inserted and control ventilation was performed during tumor resection. Gradually ventilation became difficult and SpO2 dropped necessitating tracheal intubation. A part of the tumor fell away and ventilation became easier. The operation was completed without major complications.

PMID: 22571129 [PubMed - in process]

Permalink for 'Ki-67 proliferative index predicts progression-free survival of patients with well-differentiated ileal neuroendocrine tumors.'

Ki-67 proliferative index predicts progression-free survival of patients with well-differentiated ileal neuroendocrine tumors.

Fetched: May 13th, 2012, 11:00pm MDT

Ki-67 proliferative index predicts progression-free survival of patients with well-differentiated ileal neuroendocrine tumors.

Hum Pathol. 2012 Apr;43(4):489-95

Authors: Dhall D, Mertens R, Bresee C, Parakh R, Wang HL, Li M, Dhall G, Colquhoun SD, Ines D, Chung F, Yu R, Nissen NN, Wolin E

Abstract
Ki-67 proliferative index (Ki-67 index) is suggested to be an important prognostic variable and is included as one of the grading parameters for neuroendocrine tumors. The present study was undertaken to determine the usefulness of the Ki-67 index and the corresponding tumor grade in predicting progression-free survival (PFS) of patients with ileal well-differentiated neuroendocrine tumors (wNETs). Tumors from 57 patients with ileal wNETs were studied. Immunohistochemical staining for Ki-67 was performed on the primary as well as selected metastatic tumors and quantitated by computer-assisted image analysis using the Ariol system. The tumors were graded based on mitotic activity and Ki-67 index. Clinical and pathological variables affecting the PFS were analyzed. There were 29 women and 28 men, with a mean age of 59 years. At the time of initial presentation, 8 patients (14%) had localized disease (stages I and II), 29 patients (51%) had regional (nodal/mesenteric) spread (stage III), and 20 patients (35%) had distant metastasis (stage IV). Twelve patients experienced disease progression during subsequent follow-up. Patients with initial stage IV disease were more likely to experience disease progression (P = .005). Additionally, higher histological grade (as determined by Ki-67 index >2%) was associated with a decreased PFS (P = .001). Ki-67 index greater than 2% at either the primary site or the metastatic site was found to be the only significant predictor of PFS after consideration of all other variables in an adjusted analysis. In conclusion, the Ki-67 index predicts PFS of patients with ileal wNETs.

PMID: 21937080 [PubMed - indexed for MEDLINE]

A case of resected synchronous multiple primary lung cancer comprising adenocarcinoma and carcinoid (cancer-in-cancer).

Fetched: May 11th, 2012, 11:00pm MDT

A case of resected synchronous multiple primary lung cancer comprising adenocarcinoma and carcinoid (cancer-in-cancer).

Gen Thorac Cardiovasc Surg. 2012 May 8;

Authors: Nagamatsu Y, Iwasaki Y, Omura H, Kumazoe H, Hyashida R, Shirouzu K

Abstract
We performed surgical resection of synchronous multiple primary lung cancer, comprising adenocarcinoma and carcinoid components. The latter tumor was located within the central scar tissue formed by the adenocarcinoma (cancer-in-cancer). The patient was a 67-year-old Japanese woman who had a nodular lesion in the right S1 on chest computed tomography. Lung cancer was diagnosed intraoperatively by rapid needle aspiration cytology, and right upper lobectomy with mediastinal lymph node dissection was performed. Histological examination of the resected specimen revealed cancer-in-cancer, consisting of adenocarcinoma and a carcinoid tumor. The carcinoid component was localized within the central fibrous scar of the dominant adenocarcinoma component.

PMID: 22566257 [PubMed - as supplied by publisher]

Case of peptide-YY-producing strumal carcinoid of the ovary: A case report and review.

Fetched: May 11th, 2012, 11:00pm MDT

Case of peptide-YY-producing strumal carcinoid of the ovary: A case report and review.

J Obstet Gynaecol Res. 2012 May 8;

Authors: Takatori E, Shoji T, Miura J, Takeuchi S, Yoshizaki A, Sugiyama T

Abstract
Ovarian carcinoid is a rare tumor accounting for approximately 0.1% of all ovarian malignancies. We describe a case of peptide-YY-producing strumal carcinoid of the ovary associated with severe constipation. A 48-year-old woman was found to have a pelvic mass on ultrasonography when she visited her primary doctor for a health check-up. She was thus referred to our department. Magnetic resonance imaging revealed a solid right ovarian tumor 60 × 50 mm in size. The patient underwent a right adnexectomy and was histopathologically diagnosed as having strumal carcinoid of the ovary. On immunohistochemical examination, the tumor cells were positive for peptide YY. The patient's constipation resolved rapidly after surgery. Based on her clinical course, her constipation was considered to have been caused by the strumal carcinoid of the ovary. The clinical course of this case supports the previously recognized correlation between peptide-YY-producing ovarian carcinoid and constipation.

PMID: 22563842 [PubMed - as supplied by publisher]

Excessive muscle paralysis due to pulmonary carcinoid -a case report.

Fetched: May 11th, 2012, 11:00pm MDT

Excessive muscle paralysis due to pulmonary carcinoid -a case report.

Clin Med Insights Case Rep. 2012;5:43-8

Authors: Tryfon S, Parisis V, Ioannis K, Saroglou M, Leonidas S, Despina D, Asterios K, Alexandros G

Abstract
We present the case of a 58-year-old woman with a renin secreting typical bronchopulmonary carcinoid. This patient showed hypotension, constipation and fatigue due to extensive hypokaliemia (K =1.9 meq/L). Aldosterone (102.7 ng/100 mL) and renin (46 ng/mL) were excessively elevated at that time, but cortisol level was normal. Routine chest roentgenography and computed tomography revealed a nodular lesion in the upper left lung lobe, which was suspicious for a neurosecretory pulmonary tumor. The final diagnosis was made by using bronchoscopic procedures and the histologically diagnosis was compatible as a typical pulmonary carcinoid. The tumor was resected curatively, and the renin and aldosterone level became normal. A year after the patient looks healthy.

PMID: 22563250 [PubMed - in process]

Primary pulmonary neoplasms in children: A report of five cases.

Fetched: May 11th, 2012, 11:00pm MDT

Primary pulmonary neoplasms in children: A report of five cases.

Indian J Med Paediatr Oncol. 2011 Oct;32(4):223-6

Authors: Sengupta S, Chatterjee U, Bandyopadhyay R, Bhowmick K, Banerjee S

Abstract
Primary pulmonary neoplasms are uncommon in children and represent a wide spectrum of pathology from benign to malignant. They are quite different in their histopathologic distribution from that of adults. This study was done to analyze the histopathologic spectrum of primary lung tumors in children. All the resected specimens of lung in children over a period of 5 years were studied and only the cases of primary pulmonary neoplasms were further analyzed. There were two cases of inflammatory myofibroblastic tumor. The patients were boys aged 10 and 12 years, respectively. One case of bronchial carcinoid was diagnosed in a boy of 12 years. There were one case each of pleuropulmonary blastoma (PPB) in a girl of 9 years and pulmonary blastoma (PB) in a girl of 2 years of age. In our study, the two cases of inflammatory myofibroblastic tumor had excellent prognosis. However, the cases of PPB and PB were both associated with poor clinical outcome, whereas the case of bronchial carcinoid has been doing well on follow-up.

PMID: 22563158 [PubMed - in process]

Pulmonary Carcinoid Tumors and Asbestos Exposure.

Fetched: May 11th, 2012, 11:00pm MDT

Pulmonary Carcinoid Tumors and Asbestos Exposure.

Ann Occup Hyg. 2012 May 4;

Authors: Clin B, Andujar P, Abd Al Samad I, Azpitarte C, Le Pimpec-Barthes F, Billon-Galland MA, Danel C, Galateau-Salle F, Housset B, Legrand-Cattan K, Matrat M, Monnet I, Riquet M, Pairon JC

Abstract
OBJECTIVES: The hypothesis that asbestos exposure may have more specific associations with particular histological types of lung cancer remains controversial. The aim of this study was to analyze the relationships between asbestos exposure and pulmonary carcinoid tumors. METHODS: A retrospective case-control study was conducted in 28 cases undergoing surgery for pulmonary carcinoid tumors and aged >40 years and in 56 controls with lung cancer of a different histological type, matched for gender and age, from 1994 to 1999, recruited in two hospitals in the region of Paris. Asbestos exposure was assessed via expertise of a standardized occupational questionnaire and mineralogical analysis of lung tissue, with quantification of asbestos bodies (AB). RESULTS: Definite asbestos exposure was identified in 25% of cases and 14% of controls (ns). Cumulative asbestos exposure was significantly higher in cases than in controls (P < 0.05), and results of the quantification of AB tended to be higher in cases than in controls (24 and 9% had >1000 AB per gram dry lung tissue, respectively, P = 0.09). Mean cumulative smoking was lower in cases than in controls (P < 0.05). CONCLUSIONS: This study argues in favor of a relationship between asbestos exposure and certain pulmonary carcinoid tumors.

PMID: 22562831 [PubMed - as supplied by publisher]

Malignant tumors of the small intestine: A histopathologic study of 41 cases among 1,312 consecutive pecimens of small intestine.

Fetched: May 7th, 2012, 11:00pm MDT

Malignant tumors of the small intestine: A histopathologic study of 41 cases among 1,312 consecutive pecimens of small intestine.

Int J Clin Exp Pathol. 2012;5(3):203-9

Authors: Terada T

Abstract
There are few comprehensive studies of small intestinal malignancies. The author retrospectively reviewed 1,312 archival pathologic specimens of the small intestine in the last 10 years in our pathologic laboratory in search for malignant tumors of the small intestine. There were 22 cases (1.7%) of primary adenocarcinoma, 3 cases (0.2%) of primary squamous cell carcinoma, 6 cases (0.5%) of metastatic carcinoma, 6 cases (0.5%) of malignant lymphoma, 3 cases (0.2%) of carcinoid tumor, and 1 case (0.08%) of gastrointestinal stromal tumor (GIST). Of the 25 cases of primary adenocarcinoma and squamous cell carcinoma, 24 cases were located in the duodenum and 1 case in the ileum. The 22 cases of adenocarcinoma were classified into 7 well differentiated, 7 moderately differentiated, and 8 poorly differentiated adenocarcinomas. All the three squamous cell carcinomas were moderately differentiated ones with keratinization and intercellular bridges. In the 25 cases of carcinoma, immunoreactive p53 protein was present in 23 cases, and the Ki-67 labeling ranged from 40% to 95% with a mean of 76%. In the 6 cases of metastatic adenocarcinoma, the origin was ovary in 1 case, pancreas in 2 cases, gall bladder in 1 case, lung in 1 case, and colon in 1 case. In the 6 cases of lymphoma, 4 cases were diffuse large B-cell lymphomas and 2 cases were peripheral T-cell lymphomas. In the 3 cases of carcinoid tumor, all were typical carcinoids and immunohistochemically positive for at least one of neuroendocrine markers (chromogranin, synaptophysin, neuron specific enolase, and CD56). In the 1 case of GIST, the cell type is spindle and GIST cells were immunohistochemically positive for KIT and CD34. The histological risk was intermediate. Forty-one cases of small intestinal malignancies were reviewed histopathologically.

PMID: 22558474 [PubMed - in process]

Costal metastasis: A singular localization of gastrointestinal carcinoid tumor.

Fetched: May 7th, 2012, 11:00pm MDT

Costal metastasis: A singular localization of gastrointestinal carcinoid tumor.

Ann Thorac Med. 2012 Apr;7(2):104-6

Authors: Kawamukai K, Marucci G, Saverio SD, Antonacci F, Porrello C, Boaron M

PMID: 22558016 [PubMed - in process]

Ureteric obstruction: A unique case.

Fetched: May 7th, 2012, 11:00pm MDT

Ureteric obstruction: A unique case.

Indian J Urol. 2012 Jan;28(1):96-8

Authors: Ponnusamy K, Rajesh

Abstract
The diagnosis of carcinoid tumor of the appendix is rare; the involvement is often limited to the gastrointestinal tract. Extramural involvement of surrounding structures has been reported; however, direct involvement of the ureter has not been reported. We report a case of carcinoid tumor of appendix involving the ureter and causing obstruction. To our knowledge, this is the first case report of such presentation in available literature. A 23-year-old woman who presented with right loin pain and intermittent fever for 1 week duration and found to have gross hydroureteronephrosis on the right side due to a mass compressing the ureter.

PMID: 22557728 [PubMed - in process]

Sizable but clinically inapparent adrenal pheochromocytomas.

Fetched: May 7th, 2012, 11:00pm MDT

Sizable but clinically inapparent adrenal pheochromocytomas.

J Endocrinol Invest. 2012 Mar;35(3):349-50

Authors: Yu R

PMID: 22555409 [PubMed - in process]

[Rectal goblet cell carcinoid : Primary tumor or metastasis?]

Fetched: May 7th, 2012, 11:00pm MDT

[Rectal goblet cell carcinoid : Primary tumor or metastasis?]

Pathologe. 2012 May 5;

Authors: Krümpelmann K, Hansen T, Fried-Proell W, Habekost M, Flieger D, Sommer S, Kirkpatrick CJ

Abstract
Goblet cell carcinoids are biphasic neoplasms of the gastrointestinal tract composed of a glandular and neuroendocrine differentiation. Typically, goblet cell carcinoids are localized in the vermiform appendix. We report the case of a 60-year-old female patient with the diagnosis of a 1.2-cm rectal goblet cell carcinoid tumor discovered during prophylactic proctocolonoscopy. Because of the known aggressive behavior of this entity, a rectosigmoidectomy was performed. The preoperative staging revealed neither local nor systemic spread. After 8 months, the patient is in good health. As a primary tumor of the extraappendiceal gastrointestinal tract, goblet cell carcinoids are a rarity. It is generally recommended to exclude metastasis of a primary appendiceal neoplasm. However, since the patient underwent an appendectomy in 1974, primary origin in the rectum is favored.

PMID: 22555364 [PubMed - as supplied by publisher]

Expression of Cocaine- and Amphetamine-Regulated Transcript is Associated with Worse Survival in Small Bowel Carcinoid Tumors.

Fetched: May 7th, 2012, 11:00pm MDT

Expression of Cocaine- and Amphetamine-Regulated Transcript is Associated with Worse Survival in Small Bowel Carcinoid Tumors.

Clin Cancer Res. 2012 May 2;

Authors: Landerholm K, Shcherbina L, Falkmer S, Jarhult J, Wierup N

Abstract
PURPOSE: Cocaine- and amphetamine-regulated transcript (CART) peptide exerts several regulatory functions acting both as neurotransmitter and hormone. We recently showed that CART is expressed in various neuroendocrine tumors, including small bowel carcinoids. The main objective of the present study was to examine whether CART expression is associated with survival in small bowel carcinoid patients. Secondary aims were to assess if CART expression is associated with other tumor characteristics or clinical symptoms. EXPERIMENTAL DESIGN: Specimens from 97 patients with small bowel carcinoids were examined for CART expression using immunohistochemistry. A CART score was introduced based on the proportion of CART immunoreactive cells. On inclusion, specimens were examined by routine histopathological methods and detailed clinical patient data were retrieved. The effect of CART on cell viability was assessed in vitro using two intestinal tumor cell lines.RESULTS: Expression of CART (P = 0.011), and increasing CART score (P = 0.033) were associated with worse disease-specific survival. Adjusting for age, disease stage, and tumor grade in multivariable analysis, CART expression was still associated with worse survival (Low CART hazard ratio (HR) 5.47, 95% confidence interval (CI) 0.71 to 42.46; and High CART HR 9.44, 95% CI 1.14 to 78.14). CART expression was not associated with patient age, disease stage, tumor grade, or any presenting symptom. Supporting our clinical data, we found that CART promoted tumor cell viability in vitro in two different tumor cell lines. CONCLUSION: Expression of CART in small bowel carcinoid tumors is associated with worse survival.

PMID: 22553341 [PubMed - as supplied by publisher]

Goblet cell carcinoid in ascitic fluid.

Fetched: May 7th, 2012, 11:00pm MDT

Goblet cell carcinoid in ascitic fluid.

Diagn Cytopathol. 2012 Apr 30;

Authors: Li X, Shukla P, Sinclair C, Czok S, Wei XJ, Simsir A

PMID: 22550034 [PubMed - as supplied by publisher]

Novel Association of Thymic Carcinoid with a Germline Mutation in a Kindred with Multiple Endocrine Neoplasia 1 (MEN1).

Fetched: May 7th, 2012, 11:00pm MDT

Novel Association of Thymic Carcinoid with a Germline Mutation in a Kindred with Multiple Endocrine Neoplasia 1 (MEN1).

Exp Clin Endocrinol Diabetes. 2012 Apr 27;

Authors: Khoo J, Bee YM, Giraud S, Chen RY, Rajasoorya C, Teh BT

Abstract
Multiple endocrine neoplasia 1 (MEN1) is an autosomal dominant syndrome characterized by a triad of endocrine (parathyroid, enteropancreatic and pituitary) tumors. Familial MEN1 is defined by one first-degree relative having at least one of these 3 main tumors, and is associated with germline mutations in the MEN1 gene on 11q13 in a large proportion of cases. MEN1 patients may also develop non-endocrine tumors, notably thymic carcinoid. These are rare tumors found predominantly in men, and are a major cause of death in MEN1 due to their insidious nature, lack of effective treatment and unpredictable recurrence. Prophylactic thymectomy has been advocated for prevention but continued surveillance for recurrence is necessary. Although genotype-phenotype correlation in MEN1-related thymic carcinoid is inconsistent, there is a high prevalence of truncating mutations in this condition. We describe a father and son with MEN1, associated with thymic carcinoid (father) and the truncating mutation R29X (son), which was not previously reported in MEN1-related thymic carcinoid, and review the literature about thymic carcinoids in MEN1. Our cases illustrate the importance of a high index of suspicion for early diagnosis and lifelong surveillance in MEN1, and the utility of genetic analysis in defining surveillance for MEN1-related thymic carcinoid.

PMID: 22549346 [PubMed - as supplied by publisher]

The ghost carcinoid in a patient with 120-fold elevated 5-HIAA.

Fetched: May 7th, 2012, 11:00pm MDT

The ghost carcinoid in a patient with 120-fold elevated 5-HIAA.

Endocr Pract. 2012 May 1;:1-6

Authors: Yu R

PMID: 22548955 [PubMed - as supplied by publisher]

Permalink for 'Expression profiling-based subtyping identifies novel non-small cell lung cancer subgroups and implicates putative resistance to pemetrexed therapy.'

Expression profiling-based subtyping identifies novel non-small cell lung cancer subgroups and implicates putative resistance to pemetrexed therapy.

Fetched: May 7th, 2012, 11:00pm MDT

Expression profiling-based subtyping identifies novel non-small cell lung cancer subgroups and implicates putative resistance to pemetrexed therapy.

J Thorac Oncol. 2012 Jan;7(1):105-14

Authors: Hou J, Lambers M, den Hamer B, den Bakker MA, Hoogsteden HC, Grosveld F, Hegmans J, Aerts J, Philipsen S

Abstract
INTRODUCTION: A challenge of cancer therapy is to optimize therapeutical options to individual patients. Cancers with similar histology may show dramatically different responses to therapy, indicating that a refined approach needs to be developed to classify tumors by intrinsic characteristics that may predict response to chemotherapy. Global expression profile-based classification has the potential to identify such tumor-intrinsic subclasses. Pemetrexed effectiveness has been related to the expression of its target thymidylate synthase. The relatively frequent resistance of squamous cell carcinoma to Pemetrexed is correlated with high levels of thymidylate synthase expression.
METHODS: A global expression profile-based molecular classification of non-small cell lung cancer (NSCLC) was performed. Gene expression was used to predict Pemetrexed responsiveness. The distinct molecular attributes of NSCLCs predicted likely to be resistant to Pemetrexed were bioinformatically characterized. We tested if routine immunohistochemical markers can be used to distinguish putative Pemetrexed responders, predicted by gene signatures, from nonresponders.
RESULTS: Ninety NSCLCs were divided into six subclasses by gene expression signatures. The relevance of this novel phenotyping was linked to other tumor characteristics. Two of the subclasses correlated to putative Pemetrexed resistance. In addition, the identified signature genes characterizing putative Pemetrexed responsiveness predicted therapeutic benefit in a subset of squamous cell carcinoma.
CONCLUSIONS: Gene expression signatures can be used to identify NSCLC subgroups and have potential to predict resistance to Pemetrexed therapy. We suggest that a combination of classical pathological markers can be used to identify molecular tumor subclasses associated with predicted Pemetrexed response.

PMID: 22134068 [PubMed - indexed for MEDLINE]

Management of neuroendocrine tumors in children, adolescents, and young adults.

Fetched: May 3rd, 2012, 11:00pm MDT

Management of neuroendocrine tumors in children, adolescents, and young adults.

J Pediatr Hematol Oncol. 2012 May;34 Suppl 2:S64-8

Authors: Howell DL, O'Dorisio MS

Abstract
Neuroendocrine tumors, often referred to as carcinoid tumors, are relatively rare within the pediatric and young adult populations. However, when they do occur, the more aggressive tumors can be associated with significant morbidity and even mortality in this younger age group. This article reviews the history of pediatric neuroendocrine tumors, typical clinical presentation, appropriate diagnostic studies, staging, and treatment of this unusual cancer.

PMID: 22525409 [PubMed - in process]

Phenotyping of pulmonary carcinoids and a Ki-67-based grading approach.

Fetched: May 3rd, 2012, 11:00pm MDT

Phenotyping of pulmonary carcinoids and a Ki-67-based grading approach.

Virchows Arch. 2012 Mar;460(3):299-308

Authors: Zahel T, Krysa S, Herpel E, Stenzinger A, Goeppert B, Schirmacher P, Hoffmann H, Schnabel PA, Warth A

Abstract
Pulmonary carcinoids (PC) are separated into typical (TC) and atypical carcinoids (ATC). However, the biological behavior cannot be reliably predicted, and in small biopsies differential diagnosis can be challenging. To provide a basis for a grading approach, we analyzed mitoses and the proliferative index (PI; Ki-67) of 200 PC specimens (TC: n = 114; ATC: n = 86). To define suitable diagnostic and to screen for putative therapeutic markers, CD56, CD57, CD99, CD117, TTF-1, synaptophysin, chromogranin A, CK 18, KL-1, epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (Her-2/neu), somatostatin receptor subtype 2A (SSTR2A), thymidylate synthase (TS), and excision repair cross-complementation group 1 (ERCC-1) expression was analyzed. A combination of synaptophysin and cytokeratins is the most sensitive marker panel for PC with unclear histomorphology. Predictive phenotyping revealed that SSTR2A is expressed in >80% of all PC and may be used both, as a diagnostic marker for imaging approaches and as a predictive marker for octreotide-based therapies. We introduced a grading system distinguishing between PC with low and highly aggressive biological behavior similar to the grading system for gastrointestinal neuroendocrine tumors. The system is superior to the classical separation into TC and ATC. This study indicates that PI in addition to mitotic count may improve prediction of the biological behavior of PC and should be validated in prospective studies.

PMID: 22293945 [PubMed - indexed for MEDLINE]

Beyond routine abdominal CT in the ER: a patient with indeterminate recurrent abdominal pain benefits from CT enterography.

Fetched: May 2nd, 2012, 11:00pm MDT

Beyond routine abdominal CT in the ER: a patient with indeterminate recurrent abdominal pain benefits from CT enterography.

Clin Imaging. 2012 May;36(3):231-5

Authors: Gatlin JL, Brown K, Tang SJ, Sebastian S

Abstract
We report the case of a 52-year-old female with multiple medical complaints and extensive prior clinical and imaging workup who presented to the emergency department with weakness and recurrent episodes of abdominal pain. She had had multiple inconclusive routine computed tomographic (CT) examinations. A 7-mm small bowel tumor was diagnosed on CT enterography and subsequently confirmed to be a carcinoid tumor of the ileum by enteroscopy and at surgery. The diagnosis was suggested prospectively utilizing CT enterography performed in the emergency radiology suite.

PMID: 22542385 [PubMed - in process]

Tracheal paraganglioma: an unusual neoplasm of the upper airway.

Fetched: May 2nd, 2012, 11:00pm MDT

Tracheal paraganglioma: an unusual neoplasm of the upper airway.

Ann Thorac Surg. 2012 May;93(5):1717-9

Authors: Metzdorff MT, Seaman JC, Opperman DA, Goates JJ, Musani AI

Abstract
Paraganglioma of the trachea is a rare neoplasm, with fewer than 15 cases reported. A 40-year-old man presented with stridor and hemoptysis. Bronchoscopy demonstrated a tumor of the posterior trachea and biopsy initially suggested typical carcinoid. The patient underwent surgical resection uneventfully and made a good recovery. Final pathology disclosed the tumor to be a paraganglioma based on immunohistology. The pathophysiology and treatment of this tumor are discussed.

PMID: 22541208 [PubMed - in process]

Permalink for 'Asymmetric intense bilateral adrenal uptake on [18F]fluorodeoxyglucose positron emission tomography/computed tomography in a patient with solitary pulmonary nodule.'

Asymmetric intense bilateral adrenal uptake on [18F]fluorodeoxyglucose positron emission tomography/computed tomography in a patient with solitary pulmonary nodule.

Fetched: May 2nd, 2012, 11:00pm MDT

Asymmetric intense bilateral adrenal uptake on [18F]fluorodeoxyglucose positron emission tomography/computed tomography in a patient with solitary pulmonary nodule.

J Clin Oncol. 2012 Feb 20;30(6):e83-5

Authors: Cheng MF, Lin MW, Wu CT, Shih SR, Wu YW, Tzen KY, Yen RF

PMID: 22215749 [PubMed - indexed for MEDLINE]

Permalink for 'Increased risk of neoplasm in appendicitis treated with interval appendectomy: single-institution experience and literature review.'

Increased risk of neoplasm in appendicitis treated with interval appendectomy: single-institution experience and literature review.

Fetched: April 26th, 2012, 11:00pm MDT

Increased risk of neoplasm in appendicitis treated with interval appendectomy: single-institution experience and literature review.

Am Surg. 2012 Mar;78(3):339-43

Authors: Carpenter SG, Chapital AB, Merritt MV, Johnson DJ

Abstract
Appendicitis is a common diagnosis encountered by the acute care surgeon. Management of complicated appendicitis is controversial and often involves initial nonoperative therapy with interval appendectomy. This study reviews single-institutional experience with management of complicated appendicitis with interval appendectomy and addresses an unusually high occurrence of incidental appendiceal malignancies observed with a review of relevant literature. A retrospective review of all diagnoses of appendicitis was performed over 5 years at a tertiary care center. Patient demographics, time to surgery, operative technique, pathologic diagnosis, and clinical outcomes were examined. Three hundred fifteen patients were diagnosed with acute appendicitis. Of these, 24 (7.6%) were deemed complicated and did not undergo immediate appendectomy, and 18 ultimately underwent appendectomy at our institution and were included in analysis. There were no statistical demographic or symptomatic differences between the immediate and interval appendectomy patients. Ninety-nine per cent of the immediate appendectomy patients were treated laparoscopically; 78 per cent of the interval group underwent attempted laparoscopic treatment with 56 per cent completed without conversion to open (P < 0.01). Neoplasms were discovered in 1 per cent of the acute appendectomy group and 28 per cent of the interval appendectomy group (P < 0.0001). Two of the three neoplasms in the acute group were carcinoid, whereas three of the five neoplasms in the interval group were adenocarcinoma. Surgeons should consider appendiceal or colonic neoplasms in cases of complicated appendicitis when nonoperative management is considered. This is most important in patients older than 40 years, in those who forego interval appendectomy, or in those who could be lost to follow-up.

PMID: 22524774 [PubMed - in process]

Atypical thymic carcinoid associated with coronary artery spasm: Incidental finding of myocardial perfusion imaging.

Fetched: April 26th, 2012, 11:00pm MDT

Atypical thymic carcinoid associated with coronary artery spasm: Incidental finding of myocardial perfusion imaging.

Int J Cardiol. 2012 Apr 20;

Authors: Cheng MF, Huang JJ, Chen JS, Yu SC, Yen RF, Tzen KY, Wu YW

PMID: 22521384 [PubMed - as supplied by publisher]

Inverted papilloma of the bladder: A review and an analysis of the recent literature of 365 patients.

Fetched: April 26th, 2012, 11:00pm MDT

Inverted papilloma of the bladder: A review and an analysis of the recent literature of 365 patients.

Urol Oncol. 2012 Apr 18;

Authors: Picozzi S, Casellato S, Bozzini G, Ratti D, Macchi A, Rubino B, Pace G, Carmignani L

Abstract
OBJECTIVES: Until the 1970s, inverted urothelial papilloma (IUP) of the bladder was generally regarded as a benign neoplasm. However, in the 1980s, several reported cases suggested the malignant potential of these papillomas, including cases with features indicative of malignancy, recurrent cases, and cases of IUP synchronous or metachronous with transitional cell carcinoma. The aim of this systematic review and analysis of the literature since 1990 to date is to contribute to unresolved issues regarding the biological behavior and prognosis of these neoplasms to establish some key points in the clinical and surgical management of IUP. MATERIALS AND METHODS: Database searches yielded 109 references. Exclusion of irrelevant references left 10 references describing studies that fulfilled the predefined inclusion criteria. RESULTS: One problem regarding these neoplasms is the difficulty of obtaining a correct histopathologic diagnosis. The main differential diagnosis is endophytic urothelial neoplasia, including papillary urothelial neoplasia of low malignant potential or urothelial carcinoma of low or high grade, while other considerably rare differential diagnoses include nephrogenic adenoma, paraganglioma, carcinoid tumor, cystitis cystica, cystitis glandularis, and Brunn's cell nests. The size of the lesions ranged from 1 to 50 mm (mean 12.8 mm). Most cases occurred in the fifth and sixth decade of life. The mean age of affected patients was 59.3 years (range 20-88 years). Analysis of the literature revealed a strong male predominance with a male/female ratio of 5.8:1. The most commonly reported sites of IUP were the bladder neck region and trigone. Of 285 cases included in 8 studies, 12 cases (4.2%) were multiple. Out of the total of 348 patients, 6 patients (1.72%) had a previous history of transitional cell carcinoma of the urinary bladder, 5 patients (1.43%) had synchronous transitional cell carcinoma of the urinary bladder, and 4 patients (1.15%) had subsequent transitional cell carcinoma of the urinary tract. The time before recurrence was <45 months (range 5-45 months, mean 27.7 months) after surgery. CONCLUSIONS: Inverted papilloma could be considered a risk factor for transitional cell carcinoma, and it is clinically prudent to exclude transitional cell cancer when it is diagnosed. Follow-up is needed if the histologic diagnosis is definitive or doubtful. We recommend 4-monthly flexible cystoscopy for the first year and then every 6 months for the subsequent 3 years. Routine surveillance of the upper urinary tract in cases of inverted papilloma of the lower part of the urinary tract is not deemed necessary.

PMID: 22520573 [PubMed - as supplied by publisher]

Treatment of liver metastases in patients with neuroendocrine tumors of gastroesophageal and pancreatic origin.

Fetched: April 26th, 2012, 11:00pm MDT

Treatment of liver metastases in patients with neuroendocrine tumors of gastroesophageal and pancreatic origin.

Int J Hepatol. 2012;2012:131659

Authors: Gu P, Wu J, Newman E, Muggia F

Abstract
Well-to-moderately differentiated neuroendocrine tumors of gastroesophageal and pancreatic origin (GEP-NETs) with liver metastasis are a heterogeneous group of malignancies for which a range of therapeutic options have been employed. Surgical resection of hepatic metastases or hepatic artery embolization may be beneficial in patients with hepatic-predominant metastatic disease. Patients with "carcinoid" syndrome and syndromes associated with functional pancreatic NET (PNET) can be effectively treated with somatostatin analogs. On the other hand, the efficacy of systemic chemotherapy for these patients is limited. A placebo-controlled, double-blind, prospective, and randomized study showed that octreotide LAR improves progression-free survival in patients with advanced midgut functional "carcinoids." In patients with advanced pancreatic NET, randomized, placebo-controlled studies have recently demonstrated that treatment with the tyrosine kinase inhibitor sunitinib or with mTOR inhibitor everolimus is associated with improved progression-free survival. Based on these studies, octreotide LAR, sunitinib, or everolimus are now considered as first-line therapeutic options in patients with advanced NET. Future studies will likely further define the role of these agents in patients with carcinoid liver metastasis and pancreatic NET liver metastasis.

PMID: 22518318 [PubMed - in process]

Surgical Management of Primary Appendiceal Malignancy.

Fetched: April 26th, 2012, 11:00pm MDT

Surgical Management of Primary Appendiceal Malignancy.

Colorectal Dis. 2012 Apr 19;

Authors: Whitfield C, Amin S, Garner J

Abstract
Aim: Primary appendiceal neoplasms are rare, with carcinoid being more common than carcinoma. Pre-operative diagnosis is infrequent. We report a series of 24 primary appendiceal neoplasms treated over a five year period. Method: All primary appendiceal neoplasms diagnosed in a University teaching hospital between April 2003-June 2008 were identified from the prospective histopathology database. Patient records were reviewed for clinical, operative and pathological data. Results: 14 carcinomas and 10 carcinoids were identified in the five-year period. The former presented at median age 55.8 years with median symptom duration of 35 days compared with 48 years and 3 days for carcinoids. An abdominal mass was commoner in carcinomas (8/14 versus 1/10). Six carcinomas underwent appendicectomy followed by completion right-hemicolectomy, two of which had residual disease, seven underwent primary right-hemicolectomy and one had abscess drainage. Five patients with appendiceal carcinoma died of the disease during a median follow-up of 633 [256-1158) days. Six patients underwent appendicectomy for acute appendicitis, one had a primary right-hemicolectomy for a caecal mass. Three had a subsequent right-hemicolectomy for a high-risk carcinoid. An appendiceal carcinoid was an incidental finding in three right-hemicolectomy specimens removed for other indications. No metastases or deaths were recorded at median follow-up 451 (51-975) days. Conclusion: Appendiceal carcinomas follow a more protracted clinical course than carcinoids, which usually present as acute appendicitis. Caution is needed when diagnosing simple appendicitis in older patients with longer symptom duration, particularly if a mass is present. Patients with appendiceal carcinoma should be offered completion right-hemicolectomy. Carcinoma has a poor prognosis. © 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

PMID: 22515312 [PubMed - as supplied by publisher]

Combined Use of 68Ga-DOTATATE and 18F-FDG PET/CT to Localize a Bronchial Carcinoid Associated with Ectopic ACTH Syndrome.

Fetched: April 26th, 2012, 11:00pm MDT

Combined Use of 68Ga-DOTATATE and 18F-FDG PET/CT to Localize a Bronchial Carcinoid Associated with Ectopic ACTH Syndrome.

J Clin Endocrinol Metab. 2012 Apr 23;

Authors: Därr R, Zöphel K, Eisenhofer G, Abolmaali N, Gastmeier J, Wieczorek K, Jelinek V, Kamvissi V, Bornstein SR, Hofbauer LC

Abstract
Abstract Not Available.

PMID: 22529105 [PubMed - as supplied by publisher]

[Carcinoid tumors: echocardiographic contribution to the diagnosis].

Fetched: April 26th, 2012, 11:00pm MDT

[Carcinoid tumors: echocardiographic contribution to the diagnosis].

Acta Med Port. 2011 Sep;24(5):843-8

Authors: Amador P, Mendes L, Gonçalves S, Santos JF, Seixo F, Parreira L, Soares L

Abstract
Introduction: Carcinoid tumors are rare, most commonly originating from the neuroendocrine cells in the gastrointestinal tract. Carcinoid syndrome is characterized by flushing, diarrhea, and bronchospasm. Half of these patients have carcinoid heart disease, affecting the right side of the heart, causing tricuspid and pulmonary regurgitation and stenosis and subsequently right heart failure. Case Report: 73-year-old female was admitted with heart failure associated with episodes of diarrhea and flushing. The echocardiogram showed typical characteristics of carcinoid heart diasease. The CT scan of abdomen showed a small bowel mass. The 24-hour urine 5-hydroxyindoleacetic acid (5HIAA) and indium-111-pentetreotide scintigraphy confirmed the diagnosis. The patient was treated with furosemide, warfarine, digoxin and octreotide and there was clinical improvement. Conclusion: The echocardiogram was very useful, establishing the provisory diagnosis of a rare disease based on pathognomonic echocardiographic features.

PMID: 22525639 [PubMed - in process]

Permalink for 'Efficacy of endoscopic submucosal resection with a ligation device for removing small rectal carcinoid tumor compared with endoscopic mucosal resection: analysis of 100 cases.'

Efficacy of endoscopic submucosal resection with a ligation device for removing small rectal carcinoid tumor compared with endoscopic mucosal resection: analysis of 100 cases.

Fetched: April 21st, 2012, 11:00pm MDT

Efficacy of endoscopic submucosal resection with a ligation device for removing small rectal carcinoid tumor compared with endoscopic mucosal resection: analysis of 100 cases.

Dig Endosc. 2012 May;24(3):159-63

Authors: Kim HH, Park SJ, Lee SH, Park HU, Song CS, Park MI, Moon W

Abstract
Aim Conventional endoscopic mucosal resection (EMR) of carcinoid tumors is often associated with involvement of the resection margin, which necessitates further intervention. Endoscopic submucosal resection with a ligation device (ESMR-L) is a novel technique for the removal of carcinoid tumors. The aim of the present study was to compare the clinical usefulness of endoscopic submucosal resection with a ligation device with that of EMR for the complete resection of rectal carcinoid tumors. Methods Between January 2001 and October 2010, a total of 100 patients with 100 rectal carcinoid tumors that were estimated to be 10 mm or less in diameter and that were resected either using ESMR-L or EMR were recruited for this study. The complete resection rate and complications associated with these two procedures were analyzed. Results Forty-five out of 100 lesions were resected using ESMR-L, and 55 lesions were resected using EMR. Histopathologically, all tumors were free from lymphovascular and perineural invasion. The overall ESMR-L complete resection rate was higher than that of EMR (93.3% vs 65.5%, respectively, P = 0.001). Furthermore, the location of the tumors had no influence on the complete resection rate when ESMR-L was carried out, in contrast to the results of EMR. The procedure-related variables of procedure time and complication rate were not significantly different between the two groups. Conclusion ESMR-L is a significantly superior modality to EMR for the complete removal of small rectal carcinoid tumors that are 10 mm or less in diameter.

PMID: 22507089 [PubMed - in process]

Transanal Employment of Single Access Ports Is Feasible for Rectal Surgery.

Fetched: April 21st, 2012, 11:00pm MDT

Transanal Employment of Single Access Ports Is Feasible for Rectal Surgery.

Ann Surg. 2012 Apr 12;

Authors: Barendse RM, Doornebosch PG, Bemelman WA, Fockens P, Dekker E, de Graaf EJ

Abstract
OBJECTIVE:: To evaluate the feasibility of transanal single port surgery in 15 consecutive patients. BACKGROUND:: The current method of choice for local resection of rectal tumors is transanal endoscopic microsurgery (TEM), a complex and expensive technique. Single access surgery is easy, relatively cheap, and more broadly applied in laparoscopy. Evidence regarding transanal use of single access ports is scarce. METHODS:: Consecutive patients with a rectal lesion otherwise eligible for TEM were operated using the Single Site Laparoscopic Access System (SSL) and standard laparoscopic instrumentation. Patient, lesion and procedure characteristics, hospitalization length, and peroperative and postoperative complications were recorded. RESULTS:: Fifteen patients were planned for single port transanal surgery. In 2 patients (13.3%), intrarectal retractor expansion failed, and conversion to conventional TEM was necessary. The remaining 13 patients were successfully operated. Rectal lesions (mean diameter 36 mm, standard deviation ±25 mm, mean distance from the dentate line 6 cm [±4.5]) included adenoma in 7 patients, T1 adenocarcinoma in 1, T2 adenocarcinoma in 3, carcinoid in 1, and fibrosis only in 1 (after prior polypectomy). All patients were operated in lithotomy position. Resections were en bloc, full thickness, and had complete margins. Resection specimens measured 65 (±35) × 52 (±24) mm. Twelve rectal defects were sutured. One peroperative pneumoscrotum occurred. Mean operating time was 57 (±39) minutes. One patient presented with postoperative hemorrhage, treated conservatively (postoperative morbidity rate 7.7%). Mean hospitalization lasted 2.5 days (±2.7). CONCLUSIONS:: Transanal single port surgery via the SSL is feasible and safe and may become a promising alternative to TEM.

PMID: 22504282 [PubMed - as supplied by publisher]

Ghrelin in neuroendocrine tumors.

Fetched: April 21st, 2012, 11:00pm MDT

Ghrelin in neuroendocrine tumors.

Peptides. 2011 Nov;32(11):2340-7

Authors: Vu JP, Wang HS, Germano PM, Pisegna JR

Abstract
Ghrelin is a 28 amino acid peptide, primarily produced by the oxyntic mucosa X/A like neuroendocrine cells in the stomach. It is also found in the small intestine, hypothalamus, pituitary gland, pancreas, heart, adipose tissue, and immune system. In gastrointestinal neuroendocrine tumors (NETs) ghrelin release has been well documented. Ghrelin is a brain-gut circuit peptide with an important role in the physiological regulation of appetite, response to hunger and starvation, metabolic and endocrine functions as energy expenditure, gastric motility and acid secretion, insulin secretion and glucose homeostasis, as well as in the potential connection to the central nervous system. Recently, there has been a significant interest in the biological effects of ghrelin in NETs. In this article, we present a comprehensive review of ghrelin's expression and a brief summary of ghrelin's physiological role in NETs patients with carcinoids, type A chronic atrophic gastritis (CAG), with or without MEN-1, and with and without liver metastases. We hope, with the research reviewed here, to offer compelling evidence of the potential significance of ghrelin in NETs, as well as to provide a useful guide to the future work in this area.

PMID: 22041110 [PubMed - indexed for MEDLINE]

Hepatic Artery Embolization for Neuroendocrine Tumors: Postprocedural Management and Complications.

Fetched: April 21st, 2012, 11:00pm MDT

Hepatic Artery Embolization for Neuroendocrine Tumors: Postprocedural Management and Complications.

Oncologist. 2012 Apr 17;

Authors: Lewis MA, Jaramillo S, Roberts L, Fleming CJ, Rubin J, Grothey A

Abstract
AbstractBackground. There is scant evidence to guide the management of patients after hepatic artery embolization (HAE). We examined length of stay (LOS), laboratory patterns, medication usage, morbidity, and mortality of patients hospitalized after HAE for metastatic neuroendocrine tumors.Methods. Data were abstracted retrospectively from electronic medical records on LOS, liver function tests (LFTs), i.v. antibiotics, analgesia, peak temperature, bacteremia, hepatic abscess formation, carcinoid crisis, and metastatic burden on cross-sectional imaging.Results. In 2005-2009, 72 patients underwent 174 HAEs for carcinoid and islet cell tumors. The median LOS was 4 days (range, 1-8 days). There was no correlation between peak LFTs and tumor burden. Declines in LFTs were not uniform before hospital discharge; 25%, 37%, 30%, 53%, and 67% of patients were discharged before their respective aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and total and direct bilirubin levels began to decline, with no readmissions for acute hepatic failure. The median i.v. analgesia dose was 60 mg oral morphine equivalents (range, 3-1,961 mg). Pre-HAE i.v. antibiotics were administered in 99% of cases; post-HAE fever occurred in 37% of patients, with no documented bacteremia. One patient developed a hepatic abscess after HAE. There were two carcinoid crises. The single in-hospital death was associated with air in the portal veins.Conclusions. The duration and intensity of in-hospital care following HAE should be managed on an individual basis. A downward trend in LFTs is not required before discharge. Modest use of i.v. analgesia suggests that many patients could exclusively receive oral analgesics. Given the rarity of serious complications, hospital stays could be shortened, thereby reducing costs and nosocomial risks.

PMID: 22511263 [PubMed - as supplied by publisher]

Diagnostic yield of small bowel capsule endoscopy depends on the small bowel transit time.

Fetched: April 21st, 2012, 11:00pm MDT

Diagnostic yield of small bowel capsule endoscopy depends on the small bowel transit time.

World J Gastroenterol. 2012 Apr 7;18(13):1502-7

Authors: Westerhof J, Koornstra JJ, Hoedemaker RA, Sluiter WJ, Kleibeuker JH, Weersma RK

Abstract
AIM: To investigate whether the small bowel transit time (SBTT) influences the diagnostic yield of capsule endoscopy (CE).
METHODS: Six hundred and ninety-one consecutive CE procedures collected in a database were analyzed. SBTT and CE findings were recorded. A running mean for the SBTT was calculated and correlated to the diagnostic yield with a Spearman's correlation test. Subgroup analyses were performed for the various indications for the procedure.
RESULTS: There was a positive correlation between the diagnostic yield and SBTT (Spearman's rho 0.58, P < 0.01). Positive correlations between diagnostic yield and SBTT were found for the indication obscure gastrointestinal bleeding (r = 0.54, P < 0.01), for polyposis and carcinoid combined (r = 0.56, P < 0.01) and for the other indications (r = 0.90, P <0.01), but not for suspected Crohn's disease (r = -0.40).
CONCLUSION: The diagnostic yield in small bowel capsule endoscopy is positively correlated with the small bowel transit time. This is true for all indications except for suspected Crohn's disease.

PMID: 22509082 [PubMed - in process]

Imaging features of common and uncommon bladder neoplasms.

Fetched: April 15th, 2012, 11:00pm MDT

Imaging features of common and uncommon bladder neoplasms.

Radiol Clin North Am. 2012 Mar;50(2):301-16

Authors: Mouli S, Casalino DD, Nikolaidis P

Abstract
In this article, the authors discuss imaging features of common and less-common epithelial and nonepithelial bladder neoplasms. Epithelial tumors include entities, such as urothelial cell carcinoma, squamous cell carcinoma, and adenocarcinoma, along with less-common entities, such as small cell and carcinoid tumors. Nonepithelial or mesenchymal tumors are also less commonly encountered and include benign entities, such as leiomyoma and neurofibroma, and malignant entities, including leiomyosarcoma and lymphoma. Their imaging features with an emphasis on computed tomography and magnetic resonance imaging are described.

PMID: 22498444 [PubMed - in process]

Permalink for 'Desmoglein-3 and Napsin A Double Stain, a Useful Immunohistochemical Marker for Differentiation of Lung Squamous Cell Carcinoma and Adenocarcinoma From Other Subtypes.'

Desmoglein-3 and Napsin A Double Stain, a Useful Immunohistochemical Marker for Differentiation of Lung Squamous Cell Carcinoma and Adenocarcinoma From Other Subtypes.

Fetched: April 15th, 2012, 11:00pm MDT

Desmoglein-3 and Napsin A Double Stain, a Useful Immunohistochemical Marker for Differentiation of Lung Squamous Cell Carcinoma and Adenocarcinoma From Other Subtypes.

Appl Immunohistochem Mol Morphol. 2012 Apr 10;

Authors: Agackiran Y, Ozcan A, Akyurek N, Memis L, Findik G, Kaya S

Abstract
The treatment strategy of differentiating lung carcinomas into small-cell lung carcinoma and non-small-cell lung carcinoma has been satisfactory until recently. The introduction of novel cytotoxic agents that affect a patient's response to therapy has made further differentiation important. Non-small-cell carcinoma represents a heterogeneous group of cancers with varying histologic subtypes, hence the necessity to subgroup them. In the case of adenocarcinoma and squamous cell cancer, their different responses to novel therapeutic agents and their higher occurrence make differentiation between them even more important. New markers such as desmoglein-3 (positive for squamous carcinoma) and Napsin A (positive for adenocarcinoma), which show improved specificity and sensitivity, may be particularly useful for this type of differentiation. In our study, 124 surgically resected specimens were used: 57 adenocarcinoma, 42 squamous cell carcinoma, 16 large-cell carcinoma, 1 small-cell carcinoma, and 8 typical carcinoid tumor samples. The sensitivity to desmoglein-3 and Napsin A was 92.8% and 85.9%, whereas specificity was 100% and 97%, respectively. The use of a desmoglein-3 and Napsin A double-staining strategy in our study confirmed that these markers are useful in differentiating pulmonary squamous cell carcinoma and pulmonary adenocarcinoma from other subtypes.

PMID: 22495379 [PubMed - as supplied by publisher]

Permalink for 'IMP3, NESP55, TTF-1 and CDX2 Serve as an Immunohistochemical Panel in the Distinction Among Small-cell Carcinoma, Gastrointestinal Carcinoid, and Pancreatic Endocrine Tumor Metastasized to the Liver.'

IMP3, NESP55, TTF-1 and CDX2 Serve as an Immunohistochemical Panel in the Distinction Among Small-cell Carcinoma, Gastrointestinal Carcinoid, and Pancreatic Endocrine Tumor Metastasized to the Liver.

Fetched: April 15th, 2012, 11:00pm MDT

IMP3, NESP55, TTF-1 and CDX2 Serve as an Immunohistochemical Panel in the Distinction Among Small-cell Carcinoma, Gastrointestinal Carcinoid, and Pancreatic Endocrine Tumor Metastasized to the Liver.

Appl Immunohistochem Mol Morphol. 2012 Apr 10;

Authors: Denby KS, Briones AJ, Bourne PA, Spaulding BO, Lu D, Fischer-Colbrie R, Qu Z, Wang HL, Xu H

Abstract
Histopathologic distinction among small-cell carcinoma (SCC), pancreatic endocrine tumor (PET), and gastrointestinal carcinoids metastasized to the liver in needle core biopsies can be extremely challenging because of limited material, crush artifact, and lack of detailed clinical history. In this study, a total of 61 surgically resected or biopsied specimens, including 27 SCCs (lung, 17; colon, 1; gallbladder, 2; stomach, 1; and unknown primary, 6), 18 gastrointestinal carcinoid tumors (GICTs) (stomach, 2; small intestine, 14; colon, 2), and 16 PETs were immunohistochemically examined for the expression of IMP3, TTF-1, CDX2, and NESP55 to evaluate their diagnostic value. The results showed that 24 (89%) of 27 SCCs exhibited strong cytoplasmic staining for IMP3 in 60% to 100% of the tumor cells. Eighteen (67%) SCCs were strongly and diffusely positive for TTF-1. In the remaining 9 TTF-1-negative SCCs (including 4 extrapulmonary cases), 7 showed strong and diffuse IMP3 expression. All SCCs were negative for CDX2 except for 1 case of colonic origin that showed strong CDX2 immunoreactivity. All 16 metastatic PETs were positively stained for IMP3 with 12 cases (75%) showing a diffuse and moderate-to-strong staining pattern while they were negative for TTF-1. Six PETs exhibited moderate-to-strong positivity for CDX2 with nuclear staining in 5% to 40% of tumor cells, and 5 showed a varying degree of positivity for NESP55. Three (17%) of 18 metastatic GICTs showed moderate IMP3 staining in 50% to 90% of the tumor cells, whereas CDX2 was expressed in 17 (94%) cases with moderate-to-strong staining in 50% to 100% of tumor cells. No NESP55 immunoreactivity was detected in metastatic SCCs and GICTs. In conclusion, a panel of these 4 markers is useful in segregating among SCC, PET, and GICT to help determine the primary site of hepatic metastasis.

PMID: 22495359 [PubMed - as supplied by publisher]

A Case of Carcinoid Tumor-Associated Hypercalcemia.

Fetched: April 15th, 2012, 11:00pm MDT

A Case of Carcinoid Tumor-Associated Hypercalcemia.

Cardiorenal Med. 2012 Feb;2(1):52-56

Authors: Siyam F, Abdullah O, Gardner M, Brietzke S, Sowers J

Abstract
Hypercalcemia as a complication of carcinoid tumors is extremely rare. Accordingly, we report the case of a 55-year-old male with metastatic carcinoid tumor and hypercalcemia, which corrected when the patient was treated with octreotide for symptomatic relief of watery diarrhea. The etiology of the hypercalcemia is presumed to be a neoplastic expression of fibroblast growth factor-23, which was found to be inappropriately high-to-normal when other factors such as parathyroid hormone, calcitonin and vitamin D were appropriately low or low-to-normal.

PMID: 22493603 [PubMed - as supplied by publisher]

Risk for gastric neoplasias in patients with chronic atrophic gastritis: A critical reappraisal.

Fetched: April 15th, 2012, 11:00pm MDT

Risk for gastric neoplasias in patients with chronic atrophic gastritis: A critical reappraisal.

World J Gastroenterol. 2012 Mar 28;18(12):1279-85

Authors: Vannella L, Lahner E, Annibale B

Abstract
Chronic atrophic gastritis (CAG) is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue (non-metaplastic atrophy) or by glandular structures inappropriate for location (metaplastic atrophy). Epidemiological data suggest that CAG is associated with two different types of tumors: Intestinal-type gastric cancer (GC) and type I gastric carcinoid (TIGC). The pathophysiological mechanisms which lead to the development of these gastric tumors are different. It is accepted that a multistep process initiating from Helicobacter pylori-related chronic inflammation of the gastric mucosa progresses to CAG, intestinal metaplasia, dysplasia and, finally, leads to the development of GC. The TIGC is a gastrin-dependent tumor and the chronic elevation of gastrin, which is associated with CAG, stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of TIGC. Thus, several events occur in the gastric mucosa before the development of intestinal-type GC and/or TIGC and these take several years. Knowledge of CAG incidence from superficial gastritis, its prevalence in different clinical settings and possible risk factors associated with the progression of this condition to gastric neoplasias are important issues. This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.

PMID: 22493541 [PubMed - in process]

Left main bronchus resection and reconstruction. A single institution experience.

Fetched: April 15th, 2012, 11:00pm MDT

Left main bronchus resection and reconstruction. A single institution experience.

J Cardiothorac Surg. 2012 Apr 10;7(1):29

Authors: Ragusa M, Vannucci J, Cagini L, Daddi N, Pecoriello R, Puma F

Abstract
ABSTRACT: BACKGROUND: Left main bronchus resection and reconstruction (LMBRR) is a complex surgical procedure indicated for management of inflammatory, benign and low grade malignant lesions. Its application provides maximal parenchymal sparing. METHODS: Out of 98 bronchoplastic procedures performed at the Authors' Institution in the 1995-2011 period, 4 were LMBRR. Indications were bronchial carcinoid in 2 cases, inflammatory pseudotumor in 1 case, TBC stricture in 1 case. All patients underwent preoperatively a rigid bronchoscopy to restore the airway lumen patency. At surgery a negative resection margin was confirmed by frozen section in the neoplastic patients. In all patients an end-to-end bronchial anastomosis was constructed according to Grillo. RESULTS: There were neither mortality nor major complications. Airway lumen was optimal in 3 patients, good in 1. CONCLUSION: LMBRR is a valuable option for the thoracic surgeon. It maximizes the parenchyma-sparing philosophy, broadening the spectrum of potential candidates for cure. It remains a technically demanding procedure, to be carried out by an experienced surgical team. Correct surgical planning affords excellent results, both in the short and long term.

PMID: 22490234 [PubMed - as supplied by publisher]

Bronchial carcinoid tumors metastatic to the sella turcica and review of the literature.

Fetched: April 15th, 2012, 11:00pm MDT

Bronchial carcinoid tumors metastatic to the sella turcica and review of the literature.

Pituitary. 2012 Apr 8;

Authors: Moshkin O, Rotondo F, Scheithauer BW, Soares M, Coire C, Smyth HS, Goth M, Horvath E, Kovacs K

Abstract
We review here the literature on neuroendocrine neoplasms metastatic to the pituitary and present an example of the disease. Metastasis of bronchial carcinoid tumors to the sellar region are rare. Herein, we describe the case of a 63-year-old woman who presented with constant cough and headaches. She had previously been operated for carcinoid tumor of the lung. During the preoperative investigation, a CT scan of the head revealed a sellar mass. Six months after a left lower lobectomy, the sellar lesion was removed by transsphenoidal surgery. The two tumors were evaluated by histology, immunohistochemistry and electron microscopy. Both showed identical morphologic features, those of carcinoid tumor. Immunohistochemistry revealed immunoreactivity for the endocrine markers, synaptophysin and chromogranin, as well as CD-56, serotonin, bombesin and vascular endothelial growth factor. The sellar neoplasm showed nuclear immunopositivity for thyroid transcription factor-1, supporting the diagnosis of a metastatic bronchial carcinoid tumor. In conclusion, this is the first report of a serotonin- and bombesin-immunopositive atypical bronchial carcinoid tumor metastatic to the sella.

PMID: 22485018 [PubMed - as supplied by publisher]

[Leiomyoma in Meckel's diverticulum.]

Fetched: April 15th, 2012, 11:00pm MDT

[Leiomyoma in Meckel's diverticulum.]

Gastroenterol Hepatol. 2012 Apr 4;

Authors: Pérez Moreiras MI, Alvarez Gutierrez AE, Couselo Villanueva JM, Iglesias Porto E, González López R, Arija Val F

Abstract
Meckel's diverticulum (MD) is a persistent embryonic remnant occurring in 2% of the general population. This entity is usually clinically silent and is only discovered when complications occur. Diagnosis is rarely made preoperatively. Surgical resection of symptomatic MD is widely accepted but the most appropriate management of asymptomatic MD remains unclear. We present a case of MD that summarizes some of the complications that may occur. The peculiarity of this case was that the complications were caused by a leiomyoma. The presence of tumoral disease in MD accounts for 3.2% of complications. The most common neoplasm is carcinoid tumor. Few publications have reported benign neoplasms in MD, probably due to their low incidence.

PMID: 22483017 [PubMed - as supplied by publisher]

Massive hemoptysis during pregnancy.

Fetched: April 15th, 2012, 11:00pm MDT

Massive hemoptysis during pregnancy.

J Assoc Physicians India. 2011 Oct;59:660-2

Authors: Chhajed PN, Kate A, Chaudhari P, Tulasigiri C, Shetty S, Kesarwani R, Jhawar N

Abstract
We report a case of pulmonary carcinoid presenting as massive hemoptysis in a pregnant patient. In our patient, diagnosis of carcinoid tumor was suspected after ruling out other probable and possible causes of hemoptysis. It was confirmed provisionally on flexible fiber optic bronchoscopy and later confirmed on histopathology. Our patient had two consecutive emergency surgeries, emergency cesarean section on one day followed by emergency pneumonectomy on next day. The lives of both, the mother and baby could be saved. At three month follow up, the mother did not have any symptoms.

PMID: 22479749 [PubMed - in process]

Theranostics: evolution of the radiopharmaceutical meta-iodobenzylguanidine in endocrine tumors.

Fetched: April 15th, 2012, 11:00pm MDT

Theranostics: evolution of the radiopharmaceutical meta-iodobenzylguanidine in endocrine tumors.

Semin Nucl Med. 2012 May;42(3):171-84

Authors: Sisson JC, Yanik GA

Abstract
Since 1981, meta-iodobenzylguanidine (MIBG), labeled with (131)I and later (123)I, has become a valuable agent in the diagnosis and therapy of a number of endocrine tumors. Initially, the agent located pheochromocytomas and paragangliomas (PGLs), both sporadic and familial, in multiple anatomic sites; surgeons were thereby guided to excisional therapies, which were previously difficult and sometimes impossible. The specificity in diagnosis has remained above 95%, but sensitivity has varied with the nature of the tumor: close to 90% for intra-adrenal pheochromocytomas but 70% or less for PGLs. For patients with neuroblastoma, carcinoid tumors, and medullary thyroid carcinoma, imaging with radiolabeled MIBG portrays important diagnostic evidence, but for these neoplasms, use has been primarily as an adjunct to therapy. Although diagnosis by radiolabeled MIBG has been supplemented and sometimes surpassed by newer scintigraphic agents, searches by this radiopharmaceutical remain indispensable for optimal care of some patients. The radiation imparted by concentrations of (131)I-MIBG in malignant pheochromocytomas, PGLs, carcinoid tumors, and medullary thyroid carcinoma has reduced tumor volumes and lessened excretions of symptom-inflicting hormones, but its value as a therapeutic agent is being fulfilled primarily in attacks on neuroblastomas, which are scourges of children. Much promise has been found in tumor disappearance and prolonged survival of treated patients. The experiences with therapeutic (131)I-MIBG have led to development of new tactics and strategies and to well-founded hopes for elimination of cancers. Radiolabeled MIBG is an exemplar of theranostics and remains a worthy agent for both diagnosis and therapy of endocrine tumors.

PMID: 22475426 [PubMed - in process]

Incidental finding of bulky retroperitoneal lymphadenopathy in a patient with a primary occult small gastric carcinoid tumor.

Fetched: April 6th, 2012, 11:00pm MDT

Incidental finding of bulky retroperitoneal lymphadenopathy in a patient with a primary occult small gastric carcinoid tumor.

Am Surg. 2012 Apr;78(4):224-6

Authors: Al Natour RH, Huang Q, Sharma AM, Gold JS

PMID: 22472382 [PubMed - in process]

Changing trend in distribution of gastric carcinoids: a first instance of typical sporadic gastric cardia carcinoid.

Fetched: April 6th, 2012, 11:00pm MDT

Changing trend in distribution of gastric carcinoids: a first instance of typical sporadic gastric cardia carcinoid.

Am Surg. 2012 Apr;78(4):219-21

Authors: Anbara T, Hussain Z, Daryaei P

PMID: 22472380 [PubMed - in process]

Primary neuroendocrine breast cancer, how much do we know so far?

Fetched: April 6th, 2012, 11:00pm MDT

Primary neuroendocrine breast cancer, how much do we know so far?

Med Oncol. 2012 Apr 1;

Authors: Alkaied H, Harris K, Azab B, Dai Q

Abstract
Primary neuroendocrine cancer of the breast (NECB) is an extremely rare tumor. In 2003, the World Health Organization (WHO) recognized this category with three well-described subtypes: small cell, large cell, and carcinoid-like carcinoma; very few peer-review publications based on the WHO definition were encountered in the literature, and we conducted a literature search to investigate the reported incidence, diagnosis, prognosis, hormone receptor status, and treatment options for this rare tumor. Confirming the breast as an origin of neuroendocrine tumor represents a challenge. The diagnosis is mainly dependent on the exclusion of other extra-mammary organs based on clinical, radiological, and pathological data. Except for the very rare type small cell carcinoma, estrogen and progesterone receptors were reported to be expressed in 90 and 83 % of NECB, respectively. It is hypothesized that primary breast neuroendocrine carcinoma differentiates from the epithelial cells during the carcinogenesis process; the prognosis of non-small cell primary NECB seems to improve as the amount of mucinous component increases in the tumor specimen. Management similar to interventions utilized to manage the usual ductal-type carcinoma has been attempted in the past, such as chemotherapy and hormonal therapy; however, due to the rarity of the tumor, none of the published studies are randomized nor do they have a large number of patients. Additionally, none of reports analyzed NECB based on its distinct subtypes. These limitations make recommendations largely based on anecdotal and small observatory studies and call for the need for further research in this extremely rare tumor.

PMID: 22467078 [PubMed - as supplied by publisher]

Unusually aggressive type 1 gastric carcinoid: a case report with a review of the literature.

Fetched: April 6th, 2012, 11:00pm MDT

Unusually aggressive type 1 gastric carcinoid: a case report with a review of the literature.

Eur J Gastroenterol Hepatol. 2012 May;24(5):589-93

Authors: Spampatti MP, Massironi S, Rossi RE, Conte D, Sciola V, Ciafardini C, Ferrero S, Lodi L, Peracchi M

Abstract
Gastric carcinoids are rare tumors of the stomach. Gastric carcinoid type 1 is associated with chronic atrophic gastritis, and because of a low metastatic potential, is the most benign type. Death from metastatic disease has been reported in only three patients in a review including 724 cases. The present report refers to a 60-year-old man who was affected by type 2 diabetes mellitus and pernicious anemia and died from metastatic gastric carcinoid type 1. In 1998, a well-differentiated 1.2 cm gastric neuroendocrine tumor, immunoreactive for chromogranin A, with a Ki-67 index less than 2% and with infiltration to the submucosal layer was diagnosed and enucleated. In 2002, a new well-differentiated gastric endocrine tumor 6 mm in size with a Ki-67 of approximately 2% was detected, and endoscopic ultrasound confirmed it to be limited to the submucosal layer. The patient refused antrectomy and started long-acting somatostatin analog (lanreotide) in 2005 when the Ki-67 index was 7%, but he stopped the treatment after 4 months. In 2007, despite previous endoscopic stability, endoscopic ultrasound showed an infiltrating gastric lesion of 7 cm. At surgery, the disease appeared to be extended to the liver and to the peritoneum (well-differentiated endocrine carcinoma, Ki-67 40%) with both hepatic and massive peritoneal metastases. A regimen of somatostatin analog was soon restarted; however, the disease continued to spread, and the patient died 6 months later. Overall, despite their generally benign course, type 1 gastric carcinoids may have malignant potential, a finding that should be considered when planning the medical workup of these patients.

PMID: 22465973 [PubMed - in process]

Tubular carcinoids of the appendix: the CK7/CK20 immunophenotype can be a diagnostic pitfall.

Fetched: April 6th, 2012, 11:00pm MDT

Tubular carcinoids of the appendix: the CK7/CK20 immunophenotype can be a diagnostic pitfall.

J Clin Pathol. 2012 Mar 29;

Authors: Matsukuma KE, Montgomery EA

Abstract
AimsTubular carcinoid is a rare variant of appendiceal well-differentiated neuroendocrine tumour. Although considered benign lesions, the small infiltrating tubules that characterise the tumour may raise concern for metastatic adenocarcinoma. To our knowledge, the cytokeratin 7 (CK7)/cytokeratin 20 (CK20) expression profile of these neoplasms remains unexplored.MethodsThe authors characterised the CK7/CK20 immunophenotype and Ki-67 expression of the eight available tubular carcinoids seen at their institution from 1991 to 2011.ResultsCK7 and CK20 staining was variable, ranging from none to focal staining for either or both CK7 and CK20, to diffuse expression of CK7 or CK20.ConclusionsThe CK7/CK20 expression profile is of limited value when the differential diagnosis includes primary tubular carcinoid and well-differentiated metastatic adenocarcinoma. In such cases, careful attention to the location of the neoplasm, mitotic count and presence or absence of an associated classic carcinoid component are more useful for arriving at the correct diagnosis.

PMID: 22461652 [PubMed - as supplied by publisher]

Permalink for 'Can Computed Tomographic Gastrography and Multiplanar Reformatting Aid the Laparoscopic Surgeon in Planning a Gastric Resection?: A Pictorial Essay.'

Can Computed Tomographic Gastrography and Multiplanar Reformatting Aid the Laparoscopic Surgeon in Planning a Gastric Resection?: A Pictorial Essay.

Fetched: April 6th, 2012, 11:00pm MDT

Can Computed Tomographic Gastrography and Multiplanar Reformatting Aid the Laparoscopic Surgeon in Planning a Gastric Resection?: A Pictorial Essay.

Can Assoc Radiol J. 2012 Mar 27;

Authors: Zalev AH, Grantcharov T, Deitel W

Abstract
PURPOSE: To assess the value and feasibility of computed tomographic gastrography and multiplanar reformatting in the preoperative evaluation of patients undergoing laparoscopic gastric resection. MATERIALS AND METHODS: Fourteen patients with gastric lesions were included in the study. A supine scan was performed after a hypotonic drug, an effervescent agent, and intravenous contrast. This was followed by delayed prone and decubitus scans. We created multiplanar reformats, transparency rendered images, and endoluminal images. The tumours were localized, and distances were measured to the esophagogastric junction and the pylorus. RESULTS: Eleven patients underwent resections. Seven had laparoscopic wedge resections for aberrant pancreas (1 patient), carcinoid (1), Castleman disease (1), and gastrointestinal stromal tumours (GISTs) (4). One patient had an open subtotal gastrectomy for carcinoma due to adhesions. One had a hand-assisted sleeve resection for a gastrointestinal stromal tumour. Two had hand-assisted total gastrectomies for carcinoma and a GIST. For surgical planning, the surgeon rated the imaging extremely useful in 7 and useful in 4. Imaging was extremely useful or useful to localize laparoscopically invisible tumours in 6 patients and to relate tumours to the esophagogastric junction or pylorus and to assess localized vs extensive resection in 8. Correlation was excellent between the preoperative imaging and the intraoperative findings. CONCLUSIONS: Computed tomographic gastrography and multiplanar reformatting are useful aids in preoperative planning of laparoscopic gastric resections.

PMID: 22460052 [PubMed - as supplied by publisher]

Permalink for 'A Novel Case of Concurrent Renal Tumors: Chromophobe Renal Cell Carcinoma and Carcinoid Tumor of the Kidney With Brief Review of Renal Neuroendocrine Tumors.'

A Novel Case of Concurrent Renal Tumors: Chromophobe Renal Cell Carcinoma and Carcinoid Tumor of the Kidney With Brief Review of Renal Neuroendocrine Tumors.

Fetched: March 31st, 2012, 11:00pm MDT

A Novel Case of Concurrent Renal Tumors: Chromophobe Renal Cell Carcinoma and Carcinoid Tumor of the Kidney With Brief Review of Renal Neuroendocrine Tumors.

Int J Surg Pathol. 2012 Mar 27;

Authors: Roy S, Hooda S, Huang GJ, Pantanowitz L, Parwani AV

Abstract
Renal cell carcinoma of chromophobe type is a malignant neoplasm with characteristic large cells that exhibit prominent cell membranes. Primary renal carcinoid tumors are rare tumors with the histological appearance similar to well-differentiated neuroendocrine tumors at other sites. Chromophobe renal cell carcinoma with neuroendocrine differentiation is exceedingly rare. The authors describe a case of a chromophobe renal cell carcinoma and carcinoid tumor of the kidney presenting as distinct masses in the same kidney in a 34-year-old male. The histologic and immunohistochemical features of both the tumors were characteristic with no overlapping features. The carcinoid tumor presented at a higher stage with nodal metastasis. To the best of the authors' knowledge, this is the first case of 2 morphologically distinct tumors, one chromophobe renal cell carcinoma and the other primary carcinoid tumor in the same kidney.

PMID: 22456871 [PubMed - as supplied by publisher]

[Carcinoid tumors in middle ear: one case report].

Fetched: March 31st, 2012, 11:00pm MDT

[Carcinoid tumors in middle ear: one case report].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Jan;47(1):74

Authors: Shi Y, DU B, Zhang Y

PMID: 22455784 [PubMed - in process]

The risk of metachronous cancers in patients with small intestinal carcinoid tumors: a US population-based study.

Fetched: March 31st, 2012, 11:00pm MDT

The risk of metachronous cancers in patients with small intestinal carcinoid tumors: a US population-based study.

Endocr Relat Cancer. 2012 Mar 27;

Authors: Amin S, Warner RR, Itzkowitz SH, Kim MK

Abstract
Small intestinal carcinoids (SIC) are the most common small bowel malignancies. We sought to determine the risk of developing SIC before and after other primary malignancies (PM) and the prognosis of patients with SIC, with and without another PM. We used the SEER database was used to identify patients diagnosed with SICs between 1973-2007. Multiple primary-standardized incidence ratios were calculated as an approximation of relative risk (RR) to explore the association of SICs with metachronous malignancies. Survival analysis was performed using Kaplan-Meier methods and Cox proportional-hazard models. Among 8,331 patients with SICs, 2,424 (29%) had another PM at some time. The most common sites were prostate (26.2%), breast (14.3%), colon (9.1%), lung/bronchus (6.3%), and bladder (5.3%). 67% had a PM diagnosed before the SIC (pre-SIC), 33% after (post-SIC), and 8% had a PM both before and after SIC. Among the pre-SIC group, the risk of future SIC was increased after cancers of the small bowel (RR11.86[95%CI6.13-20.72]), esophagus (4.05[1.10-10.36]), colon (1.39[1.05-1.81]), kidney (1.93[1.12-3.09]), prostate (1.38[1.17-1.62]), and leukemia (2.15[1.18-3.61]). Among the post-SIC group, there was an increased risk of future PM of the small bowel (8.78[4.54-15.34]), liver (2.49[1.08-4.91]), prostate (1.25[1.0-1.53]), and thyroid (2.73[1.10-5.62]). Compared to patients with only SIC, those with a PM pre-SIC had worse mean survival (57.9vs.40.9 months, HR1.55[1.42-1.69],p<0.001). In conclusion, almost one-third of patients with SICs have an associated metachronous primary tumor. When these primaries occur prior to (but not after) the SIC diagnosis, the prognosis is worse than with an initial SIC. The type of malignancies associated with SICs may guide future screening efforts.

PMID: 22454400 [PubMed - as supplied by publisher]

[Renal carcinoid tumor : a case report].

Fetched: March 31st, 2012, 11:00pm MDT

[Renal carcinoid tumor : a case report].

Hinyokika Kiyo. 2012 Feb;58(2):93-6

Authors: Sanjo H, Ito Y, Osaka K, Kawai M, Kobayashi K, Sakai N, Noguchi S, Kishi H

Abstract
A right renal tumor was incidentally found in a 38-year-old woman by annual medical check up. She visited our hospital for further examination and treatment. She did not show typical symptoms of carcinoid. A computed tomography (CT) revealed a calcified solid tumor in the upper portion of the right kidney. The tumor was 6.0 cm in diameter and was not enhanced in either early or late phase. There was no evidence of extrarenal invasion or distant metastasis. Based on a clinical diagnosis of stage 1 renal cell carcinoma, laparoscopic nephrectomy was performed. The pathological diagnosis was renal carcinoid tumor. The tumor had trabecular and ribbon-like structures with a thin fibrovascular stroma. Immunohistochemicaliy, the tumor cells stained positive for chromogranin A, synaptophisin and CD56. The cell proliferation rate was estimated to be under 1% with Ki67 staining. To find the primary lesion, we performed upper and lower gastric endoscopy and chest computed tomography, but could not find any/other carcinoid tumors. At 1-year follow up, she had no evidence of local recurrence or metastasis.

PMID: 22450836 [PubMed - in process]

Non tumoral hyperserotoninaemia responsive to octreotide due to dual polymorphism in UGT1A1 and UGT1A6.

Fetched: March 31st, 2012, 11:00pm MDT

Non tumoral hyperserotoninaemia responsive to octreotide due to dual polymorphism in UGT1A1 and UGT1A6.

Hormones (Athens). 2012 Jan;11(1):104-8

Authors: Maladaki A, Yavropoulou MP, Tranga T, Ventis S, Kotsa K, Yovos JG

Abstract
Gilbert's syndrome is a common inherited metabolic disorder, caused by genetic aberration in the enzyme UDP-glucuronosyl-transferase 1A1 that leads to reduced glucuronidation of bilirubin. Recent advances in molecular genetics have frequently reported the concurrence of dual genetic polymorphisms in UDP glucuronosyl-transferases 1A6 and 1A1 in patients with Gilbert's syndrome, leading to defective glucuronidation of bilirubin, as well as several other endogenous and exogenous substrates, such as serotonin. We present a case of Gilbert's syndrome with severe persistent hyperserotoninaemia, mimicking carcinoid syndrome, due to dual polymorphisms in UDP-glucuronosyl-transferases 1A1 and 1A6. The patient was treated with a long-acting somatostatin analogue (octreotide) for 8 months, resulting in a significant reduction in serum serotonin levels and immediate relief of the symptomatology, followed by a long-term remission. The frequent occurrence of hyperserotoninaemia in Gilbert's syndrome may contribute, at least partly, to the nonspecific symptomatology commonly seen in these patients and should be promptly evaluated.

PMID: 22450351 [PubMed - in process]

Malignant transformation arising from mature cystic teratoma of the ovary: A report of six cases.

Fetched: March 31st, 2012, 11:00pm MDT

Malignant transformation arising from mature cystic teratoma of the ovary: A report of six cases.

J Obstet Gynaecol Res. 2012 Mar 26;

Authors: Ulker V, Numanoglu C, Akbayir O, Akyol A, Tuncel A, Akca A, Aydin O

Abstract
Aim: Malignant transformation of mature cystic teratoma (MCT) is an uncommon complication. Preoperative diagnosis is difficult because of the lack of specific symptoms and signs indicating malignancy. Thus, we retrospectively analyzed the clinical characteristics of patients and the role of surgery in their management. Material and Methods: During a 9-year period (2002-2010), six patients with malignant transformation arising from ovarian MCT were treated at the Gynecologic Oncology Unit of Bakirkoy Woman and Children's Training and Research Hospital. A retrospective chart review and analysis of the patients' data were conducted. Results: Malignant transformation arising from ovarian MCT accounted for 1.9% of all ovarian MCT (6/321). Three cases were stage IA and the other three were stage IC. Histologically, three of six cases had squamous cell carcinoma (50%), two had a carcinoid tumor (33%), and one had mucinous adenocarcinoma (17%). All patients underwent comprehensive surgical staging. Two patients received adjuvant chemotherapy and one received adjuvant chemoradiation. Five of six patients were observed for 16-104 months and no recurrence was detected. One patient with a carcinoid tumor in stage IC died of disease within 34 months following the surgery. Conclusion: Early detection of malignant transformation arising from MCT is mandatory for treating patients, but in most patients malignancy was detected intraoperatively. Surgical cytoreduction with a complete staging procedure and adjuvant treatment may be reasonable for stage IC. Additionally, prognosis is better when the tumor is completely excised and does not extend beyond the capsule.

PMID: 22448642 [PubMed - as supplied by publisher]

Pulmonary carcinoid tumor in a patient on adalimumab for Crohn's disease.

Fetched: March 31st, 2012, 11:00pm MDT

Pulmonary carcinoid tumor in a patient on adalimumab for Crohn's disease.

Inflamm Bowel Dis. 2012 Mar 22;

Authors: Betteridge JD, Veerappan GR

PMID: 22447376 [PubMed - as supplied by publisher]

Permalink for 'A phase 2 study of the insulin-like growth factor-1 receptor inhibitor MK-0646 in patients with metastatic, well-differentiated neuroendocrine tumors.'

A phase 2 study of the insulin-like growth factor-1 receptor inhibitor MK-0646 in patients with metastatic, well-differentiated neuroendocrine tumors.

Fetched: March 31st, 2012, 11:00pm MDT

A phase 2 study of the insulin-like growth factor-1 receptor inhibitor MK-0646 in patients with metastatic, well-differentiated neuroendocrine tumors.

Cancer. 2012 Mar 21;

Authors: Reidy-Lagunes DL, Vakiani E, Segal MF, Hollywood EM, Tang LH, Solit DB, Pietanza MC, Capanu M, Saltz LB

Abstract
BACKGROUND: Neuroendocrine tumor (NET) cell lines frequently express both insulin-like growth factor (IGF) ligand and the cognate IGF-1 receptor (IGF-1R) and, as such, potentially depend on the activation of IGF-1R and its downstream effectors for growth and survival. Preclinical studies suggest that somatostatin analogs and mammalian target of rapamycin (mTOR) inhibitors exhibit antitumor activity against NETs through inhibition of IGF-1-dependent signaling, suggesting that IGF-1R inhibition may be a promising therapeutic approach to NETs. Therefore, the authors of this report evaluated the safety and efficacy of MK-0646, a fully human monoclonal antibody (MoAb) that binds to the IGF-1R, as monotherapy in patients with metastatic, well-differentiated NETs. METHODS: A phase 2 study was performed in which patients received intravenous MK-0646 10 mg/kg once weekly over 1 hour. Archived pretreatment tumor tissue was obtained and genotyped for v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS), phosphatidylinositol-3-kinase, catalytic, alpha polypeptide (PIK3CA); and v-raf murine sarcoma viral oncogene homolog B1 (BRAF) mutations, and immunohistochemistry was performed to measure the expression IGF-1R. RESULTS: Twenty-five patients received treatment (40% women; median age, 61 years; age range, 37-83 years), including 15 patients with carcinoid tumors and 10 patients with pancreatic NETs. No partial or complete responses were observed. The median progression-free survival was 4.2 months in the pancreatic NET cohort (range, 0.7-6.7 months) and 2.7 months in the carcinoid cohort (range, 2-3 months). Serious adverse events that were potentially related to MK-0646 included grade 3/4 hyperglycemia in 8 of 25 patients (32%), grade 2 hypersensitivity reaction in 1 of 24 patients (4%), and grade 3 lipase elevation in 1 of 25 patients (4%). CONCLUSIONS: Despite a compelling preclinical rationale, MK-0646 was inactive as a single agent in well-differentiated NETs. Further studies of MK-0646 as a monotherapy in unselected NETs are unwarranted. Cancer 2012;. © 2012 American Cancer Society.

PMID: 22437754 [PubMed - as supplied by publisher]

Single-institution experience on robot-assisted thoracoscopic operations for mediastinal diseases.

Fetched: March 31st, 2012, 11:00pm MDT

Single-institution experience on robot-assisted thoracoscopic operations for mediastinal diseases.

Innovations (Phila). 2011 Sep;6(5):316-22

Authors: Rea F, Schiavon M, Di Chiara F, Marulli G

Abstract
OBJECTIVE: : After the introduction of video-assisted thoracoscopic surgery 20 years ago, the minimally invasive techniques in thoracic surgery have found a growing application. The recent introduction of robotic technology has increased the potentiality of thoracoscopic technique leading to an expansion of indications and applications, particularly for the management of mediastinal diseases. We reviewed our experience in robot-assisted thoracoscopic resection of benign and malignant mediastinal diseases.
METHODS: : Between 2002 and 2010, 108 patients (79 women and 29 men; median age 38 y) underwent robot-assisted thoracoscopy using the "da Vinci" robotic system for several mediastinal diseases. There were 100 thymectomies, 3 resections of paravertebral tumors, 1 thymic cyst, 1 ectopic goitre, 1 ectopic mediastinal parathyroidectomy, 1 thymic carcinoid, and 1 foregut cyst. Ninety-five (87.9%) patients were affected by myasthenia gravis.
RESULTS: : All procedures were completed successfully using the da Vinci robot; no open conversions were required, but in three (2.8%) cases, a fourth access was added. There was no surgical mortality; four (3.6%) patients had postoperative complications (two hemothorax, one chylothorax, and one fever) treated conservatively. Median operation time was 120 (range 60-300) minutes and median hospitalization was 3 (range 2-14) days. Global benefit rate for patients with myasthenia gravis reached the value of 93.4% with progressive improvement over years.
CONCLUSIONS: : Several mediastinal operations may be feasible by using a robot-aided thoracoscopic approach. The technical innovations offered by robotic instrumentation make all procedures safer and easier when compared with standard thoracoscopic approach, with particular reference for application in mediastinal field.

PMID: 22436708 [PubMed - in process]

Pancreatic Neuroendocrine and Carcinoid Tumors: What's New, What's Old, and What's Different?

Fetched: March 31st, 2012, 11:00pm MDT

Pancreatic Neuroendocrine and Carcinoid Tumors: What's New, What's Old, and What's Different?

Curr Oncol Rep. 2012 Mar 22;

Authors: Reidy-Lagunes D, Thornton R

Abstract
Well-differentiated neuroendocrine tumors (NETs) can be subdivided into carcinoid and pancreatic NETs (panNETs). Recently, two therapies have been FDA approved for progressive well-differentiated pancreatic NETs but have not been submitted for use in carcinoid tumors (Yao, Shah, Ito, et al. N Engl J Med 364:514-23, 2011••; Raymond, Dahan, Raoul, et al. N Engl J Med 364:501-13, 2011••). The first is sunitinib (Sutent®, Pfizer, Inc.), an orally administered, multitargeted receptor kinase inhibitor. The second targeted agent is everolimus (Afinitor®, Novartis Pharmaceuticals), a mammalian target of rapamycin (mTOR) inhibitor (Yao, Shah, Ito, et al. N Engl J Med 364:514-23, 2011••). Both agents demonstrated improved progression-free survival but can also result in non-trivial toxicities and therefore, should only be considered in patients with progressing or symptomatic pancreatic NET. This review will discuss "new" NET therapies and provides an overview of liver directed and "older" cytotoxic treatment options. We also briefly outline "what's different" by describing a recent genetics report identifying genetic mutations in panNETs. Such a discovery could potentially be used to stratify treatment and such studies are currently being investigated.

PMID: 22434313 [PubMed - as supplied by publisher]

Usefulness of endoscopic submucosal dissection for the treatment of rectal carcinoid tumors.

Fetched: March 31st, 2012, 11:00pm MDT

Usefulness of endoscopic submucosal dissection for the treatment of rectal carcinoid tumors.

Eur J Gastroenterol Hepatol. 2012 Mar 19;

Authors: Hamada Y, Tanaka K, Tano S, Katsurahara M, Kosaka R, Noda T, Aoki M, Toyoda H, Takei Y, Katayama N

Abstract
BACKGROUND AND AIM: Various techniques of endoscopy have been developed to treat rectal carcinoids. This retrospective study aimed to evaluate the feasibility and efficacy of endoscopic submucosal dissection for the treatment of rectal carcinoids smaller than 10 mm in diameter. PATIENTS AND METHODS: A total of 18 consecutive patients were enrolled with 20 carcinoid tumors that had the following characteristics: the diagnosis of a rectal carcinoid smaller than 10 mm, no endoscopic evidence of muscularis propria invasion, and no evidence of lymph node or distant metastasis (11 men and seven women; median age, 69 years; median tumor size, 4 mm). Tumors were resected by endoscopic submucosal dissection with a needle knife and a hook knife. After marking, a one-third to one-half circumferential mucosal incision was made, and subsequently, the submucosa under the lesion was exfoliated. After the submucosa under the tumor was exfoliated, the residual mucosa was incised and the tumor was removed. Complete resection, complication rates, and operation time were evaluated. RESULTS: Complete resection was achieved in all cases (100%) without complications. The mean operation time was 34.2 min, which was acceptable in clinical practice. CONCLUSION: Endoscopic submucosal dissection with the strategy described above is feasible and efficacious for selected patients with a rectal carcin-oid smaller than 10 mm.

PMID: 22433790 [PubMed - as supplied by publisher]

Carcinoid crisis induced by repeated abdominal examination.

Fetched: March 31st, 2012, 11:00pm MDT

Carcinoid crisis induced by repeated abdominal examination.

Intern Med J. 2012 Mar;42(3):342-4

Authors: Morrisroe K, Sim IW, McLachlan K, Inder WJ

PMID: 22432991 [PubMed - in process]

Permalink for 'Live/Real time three-dimensional transthoracic echocardiographic assessment of the involvement of cardiac valves and chambers in carcinoid disease.'

Live/Real time three-dimensional transthoracic echocardiographic assessment of the involvement of cardiac valves and chambers in carcinoid disease.

Fetched: March 31st, 2012, 11:00pm MDT

Live/Real time three-dimensional transthoracic echocardiographic assessment of the involvement of cardiac valves and chambers in carcinoid disease.

Echocardiography. 2012 Mar;29(3):E72-7

Authors: Dumaswala B, Bicer EI, Dumaswala K, Donmez C, Bhagatwala KD, Karia N, McKay J, Joshi D, Sadat K, Nanda NC

Abstract
We present an adult with metastatic carcinoid disease affecting the heart, in whom live/real time three-dimensional transthoracic echocardiography (3DTTE) provided incremental value over two-dimensional transthoracic echocardiography (2DTTE). Initial 2DTTE was able to demonstrate severe pulmonic and tricuspid regurgitation, but was unable to visualize the posterior leaflet of the tricuspid valve or the right (right anterior) leaflet of the pulmonic valve. Further analysis with 3DTTE demonstrated thickening, restricted mobility, and noncoaptation of all three leaflets of both the tricuspid and the pulmonary valves. En face viewing of tricuspid and pulmonary regurgitation vena contractas permitted more reliable quantification of regurgitation severity. In addition, localized, linear, echogenic areas consistent with carcinoid deposits were noted along the inner walls of the right atrium, atrial septum, and inferior vena cava. To the best of our knowledge, endocardial carcinoid deposits have never been reported by 2D or 3D echocardiography. En face viewing of these deposits by 3DTTE enabled measurement of their dimensions and areas. Subcostal examination also identified large circumscribed hepatic lesions consistent with metastatic disease. Neither the carcinoid deposits nor the metastatic lesions were detected by 2DTTE. This case demonstrates the usefulness of 3DTTE as a supplement to 2DTTE in more comprehensively assessing carcinoid involvement of the heart.(Echocardiography 2012;29:E72-E77).

PMID: 22432650 [PubMed - in process]

5-HIAA excretion is not associated with bone metabolism in carcinoid syndrome patients.

Fetched: March 31st, 2012, 11:00pm MDT

5-HIAA excretion is not associated with bone metabolism in carcinoid syndrome patients.

Bone. 2012 Mar 8;

Authors: van Dijk SC, de Herder WW, Kwekkeboom DJ, Zillikens MC, Feelders RA, van Schaik RH, van Driel M, van Leeuwen JP

Abstract
In patients with a carcinoid syndrome and neuroendocrine tumors of the digestive tract (carcinoids), elevated circulating serotonin (5-hydroxytryptamine, 5-HT) levels can be demonstrated. It can be hypothesized that bone metabolism will be affected in these patients, since serotonin receptors are expressed on bone cells and serotonin effects on bone have been demonstrated. However, to date, no data are available on bone metabolism parameters in patients with neuroendocrine tumors of the digestive tract (carcinoids). In the current retrospective study we have measured serum bone formation markers P1CP (pro-collagen type I C-terminal), and osteocalcin, and the bone resorption marker NTx (collagen breakdown product N-terminal), in a group of 61 carcinoid patients with increased circulating serotonin levels as demonstrated by increased excretion of the serotonin breakdown product, 5-hydroxy indole acetic acid (5-HIAA), in the urine (>50μmol/24h, so-called "hyper-secretors") and a control group of 23 carcinoid patients, without increased 5-HIAA excretion (so-called non-secretors). The 24-h urinary excretion of 5-HIAA reflects the 24-h production of serotonin. Measurements of markers of bone metabolism were performed in serum samples obtained before the start of medical treatment. The hypersecretor group had on average a 10-fold higher urinary 5-HIAA excretion than the control (non-secretor) group. No significant differences in bone metabolism parameters could be demonstrated between hyper-secretors and controls (non-secretors). Correlation and regression analyses could not demonstrate significant age- and sex-adjusted correlations between urinary 5-HIAA excretion and any of the markers for bone turnover. A limitation is that the exposure time to elevated levels of serotonin is unknown, which might have been too short to induce effects on bone metabolism. Treatment of human pre-osteoblasts SV-HFO with serotonin didn't change alkaline phosphatase activity throughout differentiation as well as mineralization. In conclusion, the current study in a unique group of untreated carcinoid patients could not demonstrate a major role for circulating serotonin in the control of bone metabolism.

PMID: 22425693 [PubMed - as supplied by publisher]

[Preneoplastic lesions of pulmonary carcinoma].

Fetched: March 31st, 2012, 11:00pm MDT

[Preneoplastic lesions of pulmonary carcinoma].

Pathologe. 2011 Nov;32 Suppl 2:218-23

Authors: Bubendorf L

Abstract
The World Health Organization (WHO) 2004 classification includes 3 categories of pulmonary preneoplastic lesions, including squamous dysplasia and carcinoma in situ (CIS) for squamous cell carcinoma, atypical adenomatous hyperplasia (AAH) for the majority of adenocarcinomas and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) for carcinoids. The distinction of the 3 grades of squamous dysplasia and CIS is mainly based on the degree by which the basal cell zone is expanded, the degree of cellular atypia and the level of mitoses. The category AAH consists of a proliferation of atypical epithelial cells with Clara cells or type 2 pneumocyte features. They grow along the alveolar septae in a lepidic fashion, sometimes reaching into the terminal bronchioles. In contrast to the newly described adenocarcinoma in situ (AIS), AAH is smaller (≤ 5 mm), has a lower cell density and a lower degree of cellular atypia. The putative cancer stem cells of peripheral adenocarcinomas reside in the bronchioloalveolar duct junction, while those of central squamous cell carcinomas are located in the basal cell compartment of the bronchi. This review provides an overview of the current knowledge on preneoplastic lesions of the lungs and their clinical impact.

PMID: 22033683 [PubMed - indexed for MEDLINE]

Two-point fixed endoscopic submucosal dissection in rectal tumor (with video).

Fetched: March 31st, 2012, 11:00pm MDT

Two-point fixed endoscopic submucosal dissection in rectal tumor (with video).

Gastrointest Endosc. 2011 Nov;74(5):1132-6

Authors: Motohashi O

Abstract
BACKGROUND: Polypectomy, EMR, transanal endoscopic microsurgery, and surgery have been performed as treatments of rectal tumors. Endoscopic procedures are the least-invasive treatments for patients. Complete resection of the lesion is required to prevent its recurrence, and endoscopic submucosal dissection (ESD) has begun to be performed. With increasing requirements for safety, reliability, and simplicity in ESD, we decided to use a 2-point fixed ESD with a transparent hood fitted with a mucosal forceps channel in a case of a rectal tumor and report its usefulness.
OBJECTIVE: To evaluate the safety, simplicity, and usefulness of 2-point fixed ESD performed on a rectal tumor.
DESIGN: Case series.
SETTING: Kanagawa Cancer Center Hospital.
MAIN OUTCOME MEASUREMENTS: Safety, simplicity, and usefulness of 2-point fixed ESD performed on a rectal tumor.
RESULTS: The mean duration of the procedure was 45 minutes (range 30-110 minutes). Hemostasis and manipulation of the vessels were easy in all patients who did not have postoperative bleeding, perforation, or retroperitoneal emphysema as complications.
LIMITATIONS: Uncontrolled study.
CONCLUSION: This study of 2-point ESD performed in 12 patients with rectal lesions revealed that the 2-point ESD with a transparent hood fitted with a mucosal forceps channel is a useful auxiliary device, enabling safe and reliable ESD on a rectal lesion.

PMID: 21944316 [PubMed - indexed for MEDLINE]

Cocaine- and amphetamine-regulated transcript in neuroendocrine tumors.

Fetched: March 31st, 2012, 11:00pm MDT

Cocaine- and amphetamine-regulated transcript in neuroendocrine tumors.

Neuroendocrinology. 2011;94(3):228-36

Authors: Landerholm K, Falkmer SE, Järhult J, Sundler F, Wierup N

Abstract
BACKGROUND/AIMS: Cocaine- and amphetamine-regulated transcript (CART) is an anorexigenic regulatory peptide highly expressed in the brain's appetite control centers, but also in peripheral neurons and in endocrine cells in the adrenal medulla, thyroid, pancreatic islets, and in the gastrointestinal tract. Plasma levels of CART were recently shown to be elevated in patients with neuroendocrine tumors (NETs), but the cellular sources of CART in NETs have remained unknown. The aim of the study was to establish whether CART is expressed in various types of NETs and, if so, to examine the frequency, distribution and phenotype of CART-expressing cells.
METHODS: Tumor specimens from 133 NETs originating in the stomach, ileum, rectum, pancreas and thyroid were examined with immunohistochemistry and in situ hybridization. The expression of CART was quantified and the CART-expressing cells were phenotyped by double staining for established markers and hormones.
RESULTS: CART-expressing tumor cells were found in the majority of the examined NETs. The expression pattern of CART was highly heterogeneous not only between tumors, but also within individual tumors. In 14% of the NETs, CART was found in a major population of the tumor cells.
CONCLUSION: CART is produced in the majority of NETs, regardless of tumor origin. This likely explains the elevated levels of circulating CART in certain NETs patients, as recently described. CART could therefore prove to be a useful tool in the diagnostics of NETs not only in blood samples, but also in histopathological specimens.

PMID: 21832817 [PubMed - indexed for MEDLINE]

[An unusual cause of occlusion].

Fetched: March 31st, 2012, 11:00pm MDT

[An unusual cause of occlusion].

Rev Med Interne. 2011 Dec;32(12):768-9

Authors: Lamboley JL, Le Moigne F, de Charry C, Stoltz A, Milou F, Le Berre J, Salamand P

PMID: 21269739 [PubMed - indexed for MEDLINE]

Rare Cancer News & Clinical Trials » PubMed - Carcinoid

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PubMed - Carcinoid (81 unread)

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