Evaluation of clinical value of PET-CT in pulmonary carcinoid / 中华胸心血管外科杂志

Objective To assess the performance of PET-CT in pulmonary carcinoid and to evaluate the efficacy of lymph node metastasis.Methods We retrospectively collected the data of 33 patients with primary pulmonary carcinoid in our center between November 2008 and March 2017.The results of PET-CT were analysed and the relationship among pathological sub-type, tumor size and SUVmax was compared.Results Thirty-three patients had a diagnosis of carcinoid tumor, typical in 10 patients and atypical in 23 patients.The major axis of the tumor was positively correlated with the SUVmax value (P<0.001), and the mean SUVmax of the atypical carcinoid was higher than that of the typical carcinoid(11.27 vs 3.54).The major axis of the tumor was controlled.One-way covariance analysis suggested that the pathological subtype was related to SUVmax(P=0.012).Overall, PET-CT had a sensitivity of 66.7％(95％CI: 12.5％-98.2％) and specificity of 90.9％(95％CI:83. 0％-95.5％).Conclusion Atypical carcinoids showed higher SUVmax than typical carcinoids, but the PET-CT perform-ance of lung carcinoids is not specific.There was a high specificity in evaluating lymph node metastasis.

Current Consensus on I-131 MIBG Therapy / 대한핵의학회잡지

Metaiodobenzylguanidine (MIBG) is structurally similar to the neurotransmitter norepinephrine and specifically targets neuroendocrine cells including some neuroendocrine tumors. Iodine-131 (I-131)-labeled MIBG (I-131 MIBG) therapy for neuroendocrine tumors has been performed for more than a quarter-century. The indications of I-131 MIBG therapy include treatment-resistant neuroblastoma (NB), unresectable or metastatic pheochromocytoma (PC) and paraganglioma (PG), unresectable or metastatic carcinoid tumors, and unresectable or metastatic medullary thyroid cancer (MTC). I-131 MIBG therapy is one of the considerable effective treatments in patients with advanced NB, PC, and PG. On the other hand, I-131 MIBG therapy is an alternative method after more effective novel therapies are used such as radiolabeled somatostatin analogs and tyrosine kinase inhibitors in patients with advanced carcinoid tumors and MTC. No-carrier-aided (NCA) I-131 MIBG has more favorable potential compared to the conventional I-131 MIBG. Astatine-211-labeled meta-astatobenzylguanidine (At-211 MABG) has massive potential in patients with neuroendocrine tumors. Further studies about the therapeutic protocols of I-131 MIBG including NCA I-131 MIBG in the clinical setting and At-211 MABG in both the preclinical and clinical settings are needed.

Doença de Crohn associada a tumor carcinoide gástrico: relato de caso e revisão de literatura / Crohns disease associated with gastric carcinoid tumor: a case report and literature review

Os tumores carcinoides gástricos são neoplasias raras, derivadas das células enterocromafins e podem associar-se a doenças inflamatórias intestinais, como a doença de Crohn. Atualmente, há aumento da incidência devido a maior realização de endoscopia digestiva alta. A abordagem depende do tipo, tamanho e número de lesões, além da presença de metástases. Este é o relato de caso de um paciente com doença de Crohn associada a tumor carcinoide gástrico.

The gastric carcinoid tumors are rare, derived from the enterochromaffin cells and may be associated with inflammatory bowel diseases such as Crohns disease. Currently, there is increased incidence due to higher performing endoscopy. The approach depends on the type, size, number of lesions and the presence of metastases. This is a case report of a patient with Crohns disease associated with gastric carcinoid tumor.

Pigmented Choroidal Metastases Masquerading as Choroidal Melanoma

PURPOSE: To report the first case of pigmented choroidal metastases without enucleation diagnosed with fine-needle aspiration biopsy. CASE SUMMARY: A 47-year-old male was referred to our clinic with a suspected diagnosis of choroidal melanoma in his left eye. Positron emission tomography-computer tomography used to evaluate systemic metastases revealed lung cancer. Pathology of the detected lung mass was primary lung neuroendocrine tumor. To differentiate choroidal metastasis and primary choroidal melanoma, we performed a fine-needle aspiration biopsy for choroidal tumors. The cytology showed results favoring metastatic atypical carcinoid and the patient was started on systemic chemotherapy. CONCLUSIONS: All pigmented choroidal tumors are not choroidal melanomas and choroidal metastases may be pigmented. The present case suggests that proper systemic evaluation and biopsy for suspected choroidal tumor could be helpful in diagnosis.

Tumores carcinoides pulmonares tratados quirúrgicamente valor pronóstico de la 7ª estadificación TNM

Con el objetivo de evaluar el valor pronóstico de la 7a estadificación TNM se analizaron 43 mujeres (61%) y 28 hombres (39%) con diagnóstico de tumor carcinoide tratados quirúrgicamente desde enero/1975 hasta diciembre/2011. Mediana de edad: 38 años (13-67). Presentaron carcinoide típico (CT) 63 (89%) pacientes y 8 (11%) carcinoide atípico (CA). Mediana de seguimiento: 4 años (1 - 24 años). Los estadios correspondientes a CT fueron: IA = 33 (52%), IB = 10 (16%), IIA = 2 (3%), IIB = 2 (3%), IIIA = 12 (19%) y IIIB = 2 (3%); para los CA fueron: IA = 1 (12.5%), IIB = 1 (12.5%), IIIA = 2 (25%) y IIIB = 4 (50%). No hubo diferencia estadísticamente significativa en la supervivencia global a cinco años en el análisis estratificando por estadios (p = 0.689), ni analizando separadamente cada tipo histológico (CT p = 0.547; CA p = 0.592). El intervalo libre de enfermedad fue significativamente menor (CT: 3 años vs CA: 2 años, p = 0.000) y las recaídas más frecuentes en el grupo de carcinoides atípicos (CA: 50% vs CT: 2%, p = 0.000). Los pacientes con CT presentaron buena evolución aun en estadios avanzados, mientras que los que tuvieron CA presentaron menor tiempo de supervivencia e intervalo libre de enfermedad, y mayor frecuencia de recurrencia. El subtipo histológico resultó un factor significativo de pronóstico, mientras que la 7ª estadificación TNM no contribuyó en predecir la supervivencia en los tumores carcinoides.

We analyzed 43 women (61%) and 28 men (39%) surgically treated for carcinoid tumors from Jan/1975 to Dec/2011. Median age: 38 years (13-67). Typical carcinoid (TC) appeared in 63 (89%) patients, 8 (11%) suffered from atypical carcinoid (AC). Median follow-up: 4 years (1-24). TC stages were: IA = 33 (52%), IB = 10 (16%), IIA = 2 (3%), IIB = 2 (3%), IIIA = 12 (19%) and IIIB = 2 (3%); AC stages were: IA = 1 (12.5%), IIB = 1 (12.5%), IIIA = 2 (25%) and IIIB = 4 (50%). TNM classification did not show significant differences on 5-years survival period by stage (p = 0.689), even according to histological type (TC: p = 0.547; AC: p = 0.592). The disease-free survival rate was significantly lower (TC: 3 years vs. AC: 2 years, p = 0.000) and relapses were more frequent in AC (AC: 50% vs. TC: 2%, p = 0.000). The 7th TNM staging was not influential in estimating survival from carcinoid tumours in our population. The histological subtype was a better prognostic factor.

Quantificação do ácido 5-hidroxi-indolacético urinário por técnica caseira do nitrosonaftol comparada com ensaio de nitrosonaftol em microcoluna de cromatografia e imunoensaio enzimático / Quantification of urinary 5-hydroxyindoleacetic acid by in-house nitrosonaphthol reaction compared with nitrosonaphthol micro column chromatography and enzyme-linked immunosorbent assay

The aim of this study was to compare the colorimetric "kit" and enzyme-linked immunosorbent assay (ELISA) methods to quantify urinary 5-hydroxyindoleacetic acid through the Goldenberg's technique, exploring the potential of replacing it. 24-hour urine samples were tested by Goldenberg's assay and compared with kits. The agreement was almost perfect for the comparison of Goldenberg's assay with both colorimetric kit, and with ELISA kit, considering ≤ 7.5 mg/24h normal cutoff value. Therefore, both "kits" would be good alternatives to Goldenberg's technique due to practicality and agreement between values...

O objetivo deste estudo foi comparar métodos por kit colorimétrico e por ensaio imunossorvente ligado à enzima (ELISA) para quantificar o ácido 5-hidroxi-indolacético urinário com a técnica de Goldenberg, explorando o potencial de substituí-la. Amostras de urina de 24 horas foram testadas pela técnica de Goldenberg e com os kits. A concordância foi quase perfeita, tanto para a comparação do ensaio de Goldenberg com o kit colorimétrico quanto para com o kit ELISA, considerando normal o valor de corte de ≤ 7.5 mg/24h. Portanto, ambos os kits seriam boa alternativa para a técnica de Goldenberg devido à praticidade e à concordância entre os valores...

Clinical analysis of 21 cases with primary bronchial carcinoid tumors / 中国综合临床

Objective To investigate the clinical pathologic features and treatment scheme of primary bronchial carcinoid tumor.Methods Twenty-one cases with primary bronchial carcinoid tumors were selected as our subjects.Clinical information was recorded.Of 21 patients,17 cases were undergone surgery including 12 cases for lobectomy,2 cases for pneumonectomyin,1 case for pulmonary wedge resection and 1 case for egmental resection;Three cases were received adjuvant chemotherapy,1 case for adjuvant and radiation therapy and chemotherapy and 1 case for chemotherapy only.Results Histological classification showed that 7 cases were typical carcinoid,and other 14 cases were atypical carcinoid.Nine cases were TNM stage I,8 cases at stage Ⅱ,1 case at stage Ⅲ,3 cases at stage Ⅳ.All cases were performed follow-up for 5 years.Nineteen cases survived at 1st year and 10 cases survived at 3rd years survival.5 years survival rate was 23.8％ (5/21).Conclusion Surgical operation is proved to be the main method for treating bronchopulmonary carcinoid tumors,and surgical radical operation was recommended.

Análise da imunoexpressão da podoplanina (D2-40), da proteína nuclear Ki-67 e da catepsina D-34 e suas relações com metástase em pacientes operados por tumor carcinoide típico broncopulmonar / Analysis of the immunoexpression of podoplanin (D2-40), of the nuclear protein Ki-67, and of cathepsin D-34 and their relation to metastasis in patients operated for typical bronchopulmonary carcinoid tumor

Os tumores carcinoides broncopulmonares típicos são considerados tumores de baixo grau de malignidade, o que faz com que muitas vezes seja negligenciada sua capacidade de gerar metástases e levar a óbito. A atual impossibilidade de se fazer predições fidedignas do potencial metastático para individualizar a terapêutica e o manejo clínico do paciente portador de tumor carcinoide típico muitas vezes impõe situações de dúvida nas decisões da prática clínica diária. O conhecimento das características moleculares e genéticas desses tumores é a esperança de melhor compreensão de sua história natural, da identificação de seus fatores prognósticos e da avaliação de novas propostas terapêuticas. O objetivo deste estudo foi quantificar três imunomarcadores: o D2-40, o CD-34 e o Ki-67 e avaliar se eles são capazes de predizer metástase. Como informação adicional também foram avaliadas as variáveis clínicas e suas associações com metástases. Material e métodos: Foram analisados prontuários de 97 pacientes submetidos à cirurgia para tratamento de tumor carcinoide típico broncopulmonar e que apresentavam período de acompanhamento pós operatório de cinco anos completos. Foi estabelecido um banco de dados epidemiológicos, anátomopatológicos, cirúrgicos e clínicos relacionados à doença. Os blocos de parafina contendo os tumores primários, metastáticos e os linfonodos ressecados foram recuperados e reavaliados por dois patologistas para confirmação do diagnóstico histológico. Após confirmação diagnóstica foram realizadas as reações imunohistoquímicas para o D2-40, o CD34 e Ki-67. As variáveis demografia, gênero, idade, localização do tumor, tamanho do tumor, margem comprometida, total de linfonodos dissecados e a quantificação dos marcadores Ki-67, CD34 e podoplanina (área linfática e densidade) foram comparadas a cinco desfechos: metástase linfática; metástase em linfonodos hilares, peribrônquicos e pulmonares ipsilaterais (N1); metástase em linfonodos mediastinais...

Typical bronchopulmonary carcinoid tumors are slow-growing tumors considered to be of low malignancy, a fact that often underscores their capacity to generate metastasis that leads to death. The literature does not contain any assessment of the metastatic potential that would allow for individualized and optimized therapy that could have a positive impact upon the survival rate of patients. Genetic and biomolecular studies are the most promising venues for better comprehension of the behavior and natural history of such tumors. The objective of this investigation was to analyze three immunomarkers associated to malignity phenotypes: D2-40, CD-34, and Ki-67, and to verify whether or not they are associated to metastasis. D2-40 is a specific marker of the proliferation of the lymphatic endothelium and allows for the quantification of lymphangiogenesis. CD-34 identifies the endothelial cells of micro vessels and quantifies angiogenesis. Ki-67 in turn is a marker of neoplasia cell proliferation. As additional information several clinical variables were scrutinized for their association to metastasis. Ninety-seven subjects were assessed herein. These had undergone surgery for typical bronchopulmonary carcinoid tumor and all had complied with a full 5-year follow-up period. The paraffin blocks containing the primary and metastatic tumors and the dried lymph nodes were recovered. Once the histologic diagnosis was confirmed immunohistochemical reactions were performed for D2-40, Ki-67, and CD-34. The variables demography, gender, age, tumor site, tumor size, compromised margin, total dissected lymph nodes and quantification of D2-40 (lymphatic area and density), Ki-67 and CD-34 markers were compared to 5 outcomes: lymphatic metastasis, metastasis in hilar, peribronchic and ipsilateral pulmonary lymph nodes (N1), metastasis in ipsilateral mediastinal lymph nodes (N2), haematogenic metastasis, and lymphatic or haematogenic metastasis. It was concluded that there is...

Tumores carcinoides gastrointestinales, experiencia en Médica Sur: Gastrointestinal carcinoid tumors, experience in ''Médica Sur''

Objetivo: Evaluación de los casos de tumores carcinoides gastrointestinales en el Hospital y Fundación Clínica Médica Sur y confrontarlos con la literatura. Sede: Hospital y Fundación Clínica Médica Sur (centro de atención de tercer nivel). Diseño: Estudio retrospectivo, transversal, descriptivo, observacional. Análisis estadístico: Porcentaje como medida de resumen para variables cualitativas. Material y métodos: Se revisaron 19 casos de muestras de patología del Hospital y Fundación Clínica Médica Sur. Resultados: En este trabajo presentamos 19 casos de pacientes diagnosticados con tumores carcinoides gastrointestinales encontrados en toma de biopsias por endoscopia o piezas postquirúrgicas. Histológicamente se observaron células tumorales similares, con escaso citoplasma granular eosinófilo o núcleo redondeado moteado. Las variaciones de tamaño nuclear y celular fueron mínimas y las mitosis raras. El crecimiento celular fue predominantemente submucoso con extensión a capa muscular y serosa en algunos casos. Doce correspondieron al sexo femenino y siete, al masculino. El promedio de edad fue de 47 años. El órgano con más frecuencia de aparición fue el estómago y el apéndice cecal y los de menor frecuencia fueron el duodeno y el hígado. Conclusión: El sexo femenino predominó, constituyendo el 63% de los casos, la edad media para las mujeres fue de 49 años, coincidiendo con lo revisado en la literatura. Se encontró una incidencia aumentada en tumores de estómago y apéndice.

Objective: To evaluate the cases of gastrointestinal carcinoid tumors in the Hospital y Fundación Clínica Médica Sur, and to compare them with reports in the literature. Setting: Hospital y Fundación Clínica Médica Sur (third level health care center). Design: Retrospective, cross-sectional, descriptive, observational study. Statistical analysis: Percentage as summary measure for qualitative variables. Material and methods: We reviewed 19 cases of pathology samples from the Hospital y Fundación Clínica Médica Sur. Results: In this report we present 19 cases of patients diagnosed with gastrointestinal carcinoid tumors found in endoscopically taken biopsy samples or in postsurgical pieces. Histologically, similar tumor cells were observed with scarce granular eosinophilic cytoplasm or rounded spotted nucleus. Variations in nuclear and cellular size were minimal and mitoses were rare. Cell growth was predominantly submucous extending to the muscular and serosa layer in some cases. Twelve corresponded to women and seven to men. Average age was of 47 years. The organs most frequently affected were the stomach and the cecal appendix, the least frequent ones were the duodenum and the liver. Conclusion: Women predominated, constituting 63% of cases, mean age of women was of 49 years, coinciding with the literature. We found an increased incidence of tumors in the stomach and appendix.

Surgical treatment for pulmonary carcinoid tumors: a single-center analysis of 62 patients / 中华胸心血管外科杂志

ObjectiveTo evaluate prognostic factors and the surgical results of pulmonary carcinoid tumors.Methods We retrospectively reviewed the medical records of 62 patients who were diagnosed as pulmonary carcinoid tumors between January 2000 and October 2010 at Department of Thoracic Surgery,Shanghai Chest Hospital.The following information was available for each of the 62 patients:age,sex,pathological type,and TNM stage.ResultsThere were no operative death.The 3-year and 5-year survival rates after surgery were 92.1％ and 77.8％,respectively.Of the 62 patients,42 were diagnosed as typical carcinoid tumor,and among them,4 patients (8.3％) had lymph node metastases.Their 3-year and 5-year survival rates were 97.8％ and 94.7％,respectively.The remaining 20 patients were diagnosed as atypical carcinoid tumor,and among them,6 patients (37.5％) had lymph node metastases.Their 3-year and 5-year survival rates were 84.4％ and 58.8％,which were statistically significant compared with typical carcinoid tumor( P =0.0047 ).There was significant difference in survival rate between the patients with lymph node metastases and the patients without lymph node metastases (P =0.0048).CondusionThe main risk factors affecting survival rate of those patients who were diagnosed as pulmonary carcinoid tumors were pathological types and lymph node metastases.

Periampullary carcinoid: An uncommon tumor at an unusual site.

Gastrointestinal carcinoid tumors represent a group of well-differentiated tumors originating from various neuroendocrine cells located in the gastrointestinal mucosa and submucosa. Consequently, there is diversity in their clinical presentation, incidence at specific anatomic sites, biological behavior, hormone production, morphologic characteristics, and immunophenotype. Periampullary carcinoids are extremely rare and less then 100 patients have been reported in the world literature, that too mostly as case reports. We are reporting two cases of periampullary carcinoids, one of which presented with rare manifestation as gastrointestinal bleed and both are doing well after successful pancreatoduodenectomy.

Tumor carcinoide de la apéndice cecal: Reporte de cuatro casos en la Clínica Carlos Ardila Lülle, Floridablanca, Colombia / Carcinoid tumor of the cecal appendix: A report of four cases in the Clinica Carlos Ardila Lulle, Floridablanca, Colombia

Introducción: Los tumores carcinoides son las neoplasias más frecuentes del apéndice cecal, se caracterizan por un crecimiento lento y curso clínico asintomático, su incidencia se calcula en 1-2 casos por cada 100,000 habitantes, se encuentran en menos del 1% de las apendicetomías y se presentan con mayor frecuencia en mujeres entre la cuarta a quinta época de la vida. Por lo general se trata de lesiones pequeñas que se diagnostican luego de la apendicetomía. Metodología El presente trabajo corresponde a una descripción de casos de tumor carcinoide del apéndice cecal, realizado en el laboratorio de patología MEGA, de la Clínica Ardila Lulle (CAL) que incluye revisión de protocolos de especímenes quirúrgicos analizados entre enero 1 de 2000 y diciembre 31 de 2010. Resultados: Durante el periodo propuesto se encuentran cuatro casos de tumor carcinoide confinado al apéndice cecal en cuatro mujeres jóvenes. Tres de las lesiones presentan patrón histológico tipo A o insular y el restante un patrón tipo B o trabecular, en todos los casos se documentó reactividad con las sales de plata con la coloración de Fontana Masson y en los cuatro se encontró positividad con el marcador neuroendocrino cromogranina. Conclusión: Los tumores carcinoides de apéndice son lesiones de origen neuroendocrino, la mayoría circunscritas a la punta del órgano y de curso clínico indolente, sin embargo algunos de estos tumores tienen un comportamiento agresivo, que depende de su tamaño y de la actividad mitótica de sus células, por lo que se recomienda incluir en la evaluación diagnostica la cromogranina y el Ki67, marcadores neuroendocrino y de proliferación celular. Salud UIS 2011; 43 (2): 203-210.

Introduction: The carcinoids tumours are the most common neoplasm of the cecal appendix, are characterized by a slow growth and asymptomatic clinical course, its incidence is estimated at 1-2 cases per 100.000 inhabitants, are less than 1% of appendicectomies and occur most often in women between the fourth o fifth decade of life. Usually these are small lesions diagnosed after appendicectomy. Methodology: This work belongs to a description of cases of carcinoid tumor of cecal appendix, conduced in the MEGA anatomic pathology laboratory of Carlos Ardila Lulle Clinic (CAL), wich includes protocols review of surgical specimens analized between January 1, 2000 and December 31, 2010. Results: During the proposed period are four cases of carcinoid tumor confined to the cecal appendix in four young women. Three of the lesions have the A histological type or insular pattern, and the remainder have the B histological type or trabecular pattern, in all cases documented reactivity with silver salts with Masson-Fontana stain and all four were found positive with the neuroendocrine marker chromogragin. Conclusion: The carcinoid tumors of the apenddix are lesions of neuroendocrine origen, most of them located at the tip of the organ, and having a indolent clinical course; however some of these tumors have an aggressive behavior, which depends on its size and the mitotic activity of its cells, that's the reason why the diagnostic evaluation of neuroendocrine markers like chromogranin, and Ki67 (proliferation cell index) are recommended. Salud UIS 2011; 43 (2): 203-210.

Predição do risco individual de micrometástase do tumor carcinóide típico broncopulmonar em função de variáveis clínicas, anatomopatológicas e biomarcadores teciduais / Prediction of the individual risk of micrometastasis of the bronchopulmonary carcinoid tumors in function of clinical and anatomopathological features and biomarkers

Introdução: Os tumores carcinóides broncopulmonares típicos são proliferações malignas neuroendócrinas. Até bem pouco tempo eram consideradas como adenomas, isto é, tumores benignos. Porém com o avanço dos estudos anatomopatológicos, foi identificada a sua face maligna, pois apresenta as principais características das neoplasias malignas, quais sejam: metástase e invasão tecidual local. Além das metástases, estes tumores são capazes de produzir outra entidade ainda pouco estudada e conhecida que é a micrometástase. Estas correspondem a metástases menores que 2mm de diâmetro, que podem ou não se desenvolver, causando recidiva tumoral. Por sua vez as micrometástases são divididas em grupos de células tumorais, com diâmetro de 0,2 a 2mm e células tumorais isoladas, com diâmetro menor do que 0,2 mm. A literatura nos mostra que a incidência de micrometástase varia entre 10 a 90% dos pacientes em diversos tumores estudados. No caso dos carcinóides típicos temos pouca informação a respeito, sendo que a literatura nos mostra que a micrometástase em tumores carcinóides é considerada com fator de pior prognóstico. Porém não é o que observamos clinicamente, uma vez que temos o seguimento de inúmeros pacientes por mais de 10 anos, sem a recidiva tumoral em linfonodos mediastinais (seguimento clínicoradiológico). Objetivos: Verificar a presença de micrometástases em suas diversas formas, em pacientes portadores de carcinóide típico broncopulmonar, e verificar a possibilidade da predição do risco individual destas micrometástases em função de variáveis clínicas, anatomopatológicas e biomarcadores teciduais. Casuística e Métodos: Quarenta e nove pacientes portadores de carcinóide típico broncopulmonar com acompanhamento mínimo de 5 anos foram estudados. Todos foram submetidos a ressecção linfonodal por amostragem ou radical. As seguintes variáveis foram coletadas dos prontuários ou por entrevista: gênero, idade, localização do tumor em relação à carina...

Introduction: The typical lung carcinoids are neuroendocrine tumors. Until short time ago they were considered adenomas, that is, benign tumors. Although, due to the anatomopathologic advances, it was identified its malignant behavior, once it presents the main characteristics of the malignant tumors: matastasis and local invasion. Beyond the metastasis, this tumor is able to produce another entity not yet well studied, the micrometastasis. This corresponds to metastasis shorter than 2mm in diameter that can or not develop and cause tumoral recurrence. The micrometastasis are divided in two groups: clusters, with diameter between 0,2 and 2mm, and isolated tumor cells, with diameter less than 0,2mm. The medical literature shows that the incidence of micrometastasis of different tumors has a wide variation, between 10 to 90%. In the case of the typical lung carcinoids few information is presented, and the presence of the micrometastasis worsen prognosis. On the other hand this is not what we usually see clinically, once the follow up of numerous patients of our casuistic for more than 10 years did not show the recurrence of the desease in the mediastinal lymphnodes. Objectives: Verify the presence of micrometastasis in its various forms in patients comited by lung carcinoid tumors and verify the possibility to predict the individual risk of micrometastasis from clinical and anatomopathological variables and tissue biomarkers. Casuistic and Methods: Forty nine patients with lung carcinoid tumors with follow up of at least 5 years were studied. All of them were submitted to mediastinal lymphnode dissection during the surgical procedure. The data collected was: age, gender, tumor location (central or peripherical), diameter, compromised surgical edge, TNM stage, lymphatic metastasis, hematogenic metastasis and survive. The lymphnodes were analised by Hematoxilin-Eosin and immunohistochemistry (Synaptophysin and Chromogranin A) in order to search for micrometasta...

A Case of Rectal Carcinoid Tumor in a Child / 대한소아소화기영양학회지

Carcinoid tumors are derived from the enterochromaffin cells of neural crest origin. Most are commonly found in the gastrointestinal (GI) tract. The rectum is the third most common site for GI carcinoids. Rectal carcinoid tumors make up 13.7% of all carcinoid tumors and the vast majority occurs in the sixth decade of life. Approximately 80% of rectal carcinoid tumors are less than 1 cm in size, limited to the submucosa without metastasis and can be safely treated by local excision. We report a case of rectal carcinoid tumor in a 13 year-old child that was successfully treated by endoscopic polypectomy.

A Case of Carcinoid Tumors of the Stomach and Duodenum Treated by Endoscopy / 대한소화기내시경학회지

A carcinoid tumor is a slow growing, rare neoplasm arising from enterochromaffin cells with a malignant potential. A primary carcinoid tumor of the stomach and duodenum is uncommon. However, their prevalence has been increasing due to the widespread use of endoscopy. Recently, the use of endoscopic resection for the treatment of small carcinoid tumors is gradually increasing. To our knowledge, this is the first case report of synchronous carcinoid tumors in the stomach and duodenum. We report a case of small, multiple carcinoid tumors of the stomach and duodenum in a 58-year-old man that was endoscopically removed with a snare.

Two Cases of Multiple Carcinoid Tumors of the Rectum / 대한소화기내시경학회지

Carcinoid tumors of the rectum are relatively uncommon and comprise only about one percent of all rectal neoplasms. Typically, rectal carcinoids present as small, solitary submucosal nodules and have benign course. But, multicentricity is rare. The frequency of an associated second malignancy is about 13%. The explanation of the high frequency of other neoplasms associated with carcinoid tumors is still unclear. We have experienced two cases of multiple carcinoid tumors of the rectum, one was coexisted with adenocarcinoma of the sigmoid colon. They presented with mass on the right inguinal area and hematochezia. Carcnoids was found incidentally. Because the tumors measured 15 mm or less in diameter, did not infiltrate beyond the submucosal layer and had no histological atypia, carcinoids was treated by endoscopic polypectomy and mucosal resection. Thereafter, one underwent surgery for adenocarcinoma of the sigmoid colon. Herein we present our experience with reviewed literatures.

Primary carcinoid tumors of the pancreas:CT findings / 中华放射学杂志

Objective To evaluate the CT findings of pancreatic carcinoid tumors.Methods The CT imaging data of five patients with pancreatic carcinoid tumors confirmed by pathology were retrospectively analyzed.Results The tumors ranged in maximum diameter from 2.0 to 11.0 cm with a mean of 6.4 cm. On unenhanced CT,the tumors were slightly hypodense relative to the pancreatic parenchyma,homogenous in 2 cases,and heterogenous in 3 cases.One tumor showed calcification.After contrast material injection, the solid component of the tumor showed marked heterogenous enhancement on the arterial phase scanning in 3 cases,and mild heterogenous enhancement in 2 cases.The degree of tumor enhancement was less intense than the surrounding pancreatic parenchyma due to necrosis of various degree,which led to the cystic appearance of the tumor in 1 ease.On the portal phase scanning,all tumors showed marked enhancement similar to that of the pancreatic parenchyma.On the delayed phase scanning,the degree of enhancement was more intense than the surrounding pancreatic parenchyma in 1 case.Liver metastases with retroperitoneal lymphadenopathy and peripancreatic vessels invasion were seen in 1 case.No dilatation of the biliary tract or pancreatic duct was present.Conclusion The CT features of pancreatic carcinoid tumors included infrequent dilatation of the biliary tract or pancreatic duct and unusual vascular involvement,calcification within the mass,marked enhancement similar to that of the surrounding pancreatic parenchyma during the portal phase scanning and more intense during the delayed phase scanning.