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1.
Kyobu Geka ; 73(9): 671-674, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-32879270

RESUMO

Carcinoid arising from a mature cystic teratoma of the mediastinum is extremely rare. A 30-year-old man complaining of chest pain was admitted to our hospital for abnormal shadow in right mediastinum on chest tomography. Computed tomography (CT) and magnetic resonance imaging (MRI) suggested mature teratoma. Complete resection under video-assisted thoracotomy was performed. The postoperative course was uneventful. Histological diagnosis was mature cystic teratoma containing 3 mm component of carcinoid in the capsule. There were no pathological findings of necrosis and MIB-1-index was 1 %. No recurrence has been observed for 7 months after surgery.


Assuntos
Tumor Carcinoide , Neoplasias do Mediastino , Teratoma , Adulto , Humanos , Masculino , Mediastino , Recidiva Local de Neoplasia , Tomografia Computadorizada por Raios X
2.
Artigo em Chinês | MEDLINE | ID: mdl-32791622

RESUMO

Typical carcinoid tumors arise from neuroendocrine cells, many of which are present in the digestive tract and lungs. Tumors occurring in the nose and paranasal sinus area are very rare. We encountered a patient with a typical carcinoid tumor that arose in the sphenoid sinuses, and we report the case with a review of the literature. The patient was a 53-year-old woman presented with right-side headache and repeatedly rhinorrhea for half a year. The sinus CT revealed a soft tissue mass in the right sphenoid sinus, MR showed equal T1 signal and T2 signal tissue, and enhanced MR showed abundant blood perfusion in the arterial phase before surgery. Then the right sphenoid sinus open surgery and sphenoid sinus tumor resection was performed under nasal endoscopy, the operation was successful. The histopathological diagnosis was a typical carcinoid tumor. There was no sign of recurrence after 3 months and 14 months of follow-up.


Assuntos
Tumor Carcinoide , Neoplasias dos Seios Paranasais , Endoscopia , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Seio Esfenoidal
3.
Nihon Shokakibyo Gakkai Zasshi ; 117(7): 635-645, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32655123

RESUMO

A 69-year-old male presented for an annual medical examination, and his chest X-ray showed an abnormal shadow. He presented to our hospital, and was diagnosed with typical carcinoid tumor of the lung by bronchoscopy. We recommended surgery, however the patient did not agree to the operation. One year later, two masses were detected in the liver. Ultrasound guided biopsy revealed that they were metastases from the atypical carcinoid tumor of the lung. We recommended chemotherapy, but he refused. Six months later, he was admitted to our hospital for symptoms of flushing, fever, watery diarrhea, and palpitations. We diagnosed this combination of symptoms as carcinoid syndrome, and started the administration of a long acting release (LAR) octreotide. The patient's symptoms improved, but did not resolve completely. We then performed a hepatic artery embolization for the liver metastases, and the symptoms resolved. However, viable lesions of the liver metastases slowly grew and caused a carcinoid crisis. By increasing the dosage of octreotide up to a continuous intravenous infusion of 1500µg/day, as well as LAR 30mg/4weeks, the patient recovered from the crisis. Hepatic artery embolization was performed shortly afterward. Because it was difficult to control the carcinoid syndrome by hepatic artery embolization alone, he underwent a resection of the liver metastases. After the hepatic resection, he has had no recurrence of carcinoid syndrome while still being treated with octreotide LAR.


Assuntos
Tumor Carcinoide , Neoplasias Hepáticas , Neoplasias Pulmonares , Idoso , Humanos , Masculino , Recidiva Local de Neoplasia , Octreotida
4.
Zhonghua Zhong Liu Za Zhi ; 42(6): 438-444, 2020 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-32575937

RESUMO

Neuroendocrine neoplasms (NENs) are relatively rare heterogeneous tumors that originate from peptidergic neurons and neuroendocrine cells and have been referred to as "carcinoids" in the past. Although this type of tumor had been previously considered to be indolent tumor with a low degree of malignancy, with the development of medicine and clinical study, researchers found that NENs had the potential to metastasize. They can occur in any part of the body where neuroendocrine cells are distributed and gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) are the most common type of NENs.Due to the improvement of techniques such as endoscopy and imaging, the incidence of rectal neuroendocrine tumors(R-NENs) and the number of related clinical researches have both increased significantly in recent years. Although researches in Chinese and foreign medical centers are mostly retrospective studies of small samples and the efficacies of different treatment methods are still under debating and lack of sufficient medical evidence to support, the diagnosis and treatment of this disease is gradually becoming standardized according to the proposal of corresponding guidelines. The recent advances in the epidemiology, diagnosis and treatment of rectal neuroendocrine neoplasms are reviewed in this paper.


Assuntos
Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/terapia , Neoplasias Retais/diagnóstico , Neoplasias Retais/terapia , Tumor Carcinoide , China/epidemiologia , Endoscopia , Humanos , Tumores Neuroendócrinos/epidemiologia , Tumores Neuroendócrinos/patologia , Neoplasias Retais/epidemiologia , Neoplasias Retais/patologia
5.
Gan To Kagaku Ryoho ; 47(1): 126-128, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-32381880

RESUMO

The patient was a 26-year-old female who had undergone conservative treatment for acute appendicitis at another clinic and was referred to our hospital for interval appendectomy. We performed a single-incision laparoscopic appendectomy, and the patient was diagnosed with goblet cell carcinoid(GCC)based on the postoperative pathological examination. Since GCC is considered a high-grade tumor, we performed a laparoscopic ileocolic resection with D3 lymphadenectomy. There was no residual disease or lymph node metastasis detected in the resected specimen. Patients with advanced GCC typically have poor prognosis, because GCC is characterized by peritoneal dissemination and lymph node metastasis. However, our findings suggested that an additional laparoscopic surgery could be one of the curative and safe treatment options for selected pa- tients with GCC.


Assuntos
Tumor Carcinoide , Adulto , Apendicectomia , Neoplasias do Apêndice , Apendicite , Colectomia , Feminino , Humanos
6.
Surg Clin North Am ; 100(3): 635-648, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32402306
7.
Gan To Kagaku Ryoho ; 47(5): 839-842, 2020 May.
Artigo em Japonês | MEDLINE | ID: mdl-32408332

RESUMO

A 67-year-old man presented with abdominal distention and vomiting.Computed tomography revealed bowel obstruction due to a cecal tumor.We performed laparoscopic ileocecal resection after decompression with an ileus tube. Intraoperative findings included multiple disseminated nodules on the mesenterium surrounding the cecal tumor.The histopathologic diagnosis was poorly differentiated adenocarcinoma, which consisted of glandular proliferation of atypical epithelial cells and dispersed infiltration of goblet cells. Immunohistochemistry showed positively stained neuroendocrine markers, such as CD56, chromogranin, and synaptophysin.The patient was diagnosed with goblet cell carcinoid of the appendix and treated with combination chemotherapy of bevacizumab, fluorouracil, folinic acid, and oxaliplatin.He remained free from progression for over 1 and half years with this treatment.Subsequent chemotherapy was ineffective, and he passed away.There is no established chemotherapy regimen for goblet cell carcinoid, which has the aspects of both adenocarcinoma and neuroendocrine tumors.However, the present case suggested the efficacy of the mFOLFOX6 regimen in combination with bevacizumab for appendiceal goblet cell carcinoid.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Apêndice , Apêndice , Tumor Carcinoide , Idoso , Neoplasias do Apêndice/tratamento farmacológico , Bevacizumab , Tumor Carcinoide/tratamento farmacológico , Fluoruracila , Humanos , Leucovorina , Masculino , Compostos Organoplatínicos
8.
Scand J Immunol ; 92(2): e12893, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32433774

RESUMO

Pulmonary typical carcinoid (TC) is a low-grade, rare lung cancer of neuroendocrine origin. Currently, there is very little information available about the immune cell composition in TC tumours. Here, we analysed by flow cytometry resected tumours from four never-smoker female patients with TC. Twelve distinct immune cell types were identified in TC tumours. The most abundant immune cells were CD8+ T cells, CD4+ T cells, B cells and macrophages, which represented 19.8%, 17.7%, 11.5% and 11% of all tumour-infiltrating CD45+ leucocytes, respectively. Natural killer (NK) cells (8.8%) and neutrophils (3.9%) were also common. Three types of dendritic cells (DCs) were identified (plasmacytoid DCs, CD1c  DCs, and CD141  DCs) which together constituted 1.4% of all immune cells in TC tumours. Small populations of basophils (1.2%), mast cells (0.8%) and eosinophils (0.6%) were also present. Notably, the percentage of leucocytes (of all living cells) was much lower in TC tumours compared to high-grade non-small cell lung cancer (NSCLC) tumours and also compared to non-cancerous lung tissue. We conclude that TC tumours are relatively non-inflammatory, although the immune landscape was found to be very complex.


Assuntos
Tumor Carcinoide/imunologia , Neoplasias Pulmonares/imunologia , Microambiente Tumoral/imunologia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade
9.
Gan To Kagaku Ryoho ; 47(4): 709-711, 2020 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-32389992

RESUMO

The present case pertained to a 70-year-old woman. The fecal occult blood test was positive. Colonoscopyrevealed rectal cancer. She underwent the first operation of low anterior resection. Pathological diagnosis was carcinoid, se, ly2, v0, n1. Approximately2 months later, multiple liver metastases were found. Because of strong enhancement at angiography, transarterial chemoembolization(TACE)was selected. After 3 rounds of TACE, we operated the residual liver metastasis approximately1 year and 7 months after the first operation. However, approximately8 years and 9 months after the first operation, multiple liver metastases were found again. Hepatic arterial infusion(HAI)was chosen because tumors showed weak en- hancement on CT. First, we tried high-dose HAI(5-FU 1 g/dayat 1-3 and 5-7, amount: 6 g/week), and liver metastases was almost in CR. However, extrahepatic metastasis was found on PET-CT. Because of rapid growth, we operated the growing lymph node. Pathological diagnosis was diffuse large-cell type B-cell malignant lymphoma. Thus, we extended the interval of HAI(weekly, biweekly, and monthly)and simultaneously4 courses of R-THP-COP(R: rituximab, THP: pirarubicin, C: cyclophosphamide, O: vincristine, P: prednisolone)therapyfor malignant lymphoma was administered. She is now an outpatient. Liver metastases continue to be in CR at approximately1 year and the IL-2R value is almost within normal range.


Assuntos
Tumor Carcinoide , Quimioembolização Terapêutica , Neoplasias Hepáticas , Linfoma , Neoplasias Retais , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica , Tumor Carcinoide/secundário , Tumor Carcinoide/terapia , Feminino , Fluoruracila , Humanos , Infusões Intra-Arteriais , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Linfoma/terapia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Retais/terapia
11.
S D Med ; 73(2): 54-58, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32135052

RESUMO

Primary lung tumors are very rare in children and constitute only 0.2 percent of all pediatric malignancies. Carcinoids are the most common primary pediatric lung tumor and account for 80 percent of all primary malignant bronchial tumors. Carcinoid tumors can be histologically categorized as typical or atypical. They are derived from neuroendocrine cells in the bronchial epithelium and are locally infiltrative. Surgical resection of endobronchial carcinoid tumors is the mainstay of treatment with a five-year survival of 95 percent. Endoscopic resection has been reported in adult patients with typical carcinoid tumors (less than 20 mm) with no extrabronchial disease. We present the first pediatric bronchial carcinoid tumor treated with endoscopic resection.


Assuntos
Tumor Carcinoide , Neoplasias Pulmonares , Pneumonia , Adulto , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico , Criança , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Pneumonia/etiologia , Síndrome
12.
Chirurgia (Bucur) ; 115(1): 102-111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155405

RESUMO

Goblet cell carcinoids (GCC) are extremelyrare neuroendocrine tumours, and characterised by their unique combination of two types of cancer cells âÃÂ" neuroendocrine (carcinoid) and epithelial (adeno-carcinoma). In spite of the fact that GCC is regarded as Neuro-Endocrine Tumour (NET), it does not illicit carcinoid syndrome. GCC usually arises in the appendix and accounting for less than 14% of all appendiceal tumours.Primary extra-appendiceal GCC have been reported as stomach, duodenum, small intestine, colon and rectum. The paper presents a rare case of GCC of the ascending colon in a 57-year-old male.


Assuntos
Tumor Carcinoide/patologia , Tumor Carcinoide/cirurgia , Colo Ascendente/patologia , Neoplasias do Colo/patologia , Colectomia , Colo Ascendente/cirurgia , Neoplasias do Colo/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
14.
Ann Thorac Surg ; 110(1): e67-e69, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32114051

RESUMO

Sleeve resection and double-barreled reconstruction are very rarely adopted for peripheral bronchial tumors. This surgical procedure was used for a carcinoid tumor in the bifurcation of the left upper and lower lobe bronchi. Bronchoplasty was accomplished by suturing the upper and basal bronchi together and anastomosing them to the left main bronchus. The techniques for double-barreled reconstruction described in this report obtained a successful result. These manipulations may be applicable to resection of other bronchial and tracheal bifurcations.


Assuntos
Brônquios/cirurgia , Neoplasias Brônquicas/cirurgia , Tumor Carcinoide/cirurgia , Pneumonectomia/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Torácicos/métodos , Brônquios/diagnóstico por imagem , Neoplasias Brônquicas/diagnóstico , Broncoscopia , Tumor Carcinoide/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade
15.
Radiol Med ; 125(8): 715-729, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32189174

RESUMO

AIMS: This study analyses the capability of contrast-enhanced multi-detector computed tomography (MDCT) and spectrum of molecular imaging to characterize typical carcinoids (TCs) of lung and their relationship with Ki-67 index. MATERIALS AND METHODS: We analysed 68 patients with histological diagnosis of pulmonary TC, which underwent both MDCT and nuclear molecular imaging (somatostatin receptor scintigraphy/SPECT with 111In-pentetreotide and 18F-FDG-PET/CT) at staging evaluation before surgery. The MDCT scan was reviewed for the following features: size, margins, contrast enhancement, presence of calcifications, bronchial obstruction, lymph nodes and metastases. In 111In-pentetreotide SPECT, tumour/non-tumour ratio was measured at 4- and 24-h post-injection and the per cent difference was calculated (T/NT%). FDG uptake was measured as the ratio between lesion SUVmax and liver SUVmean (SUV ratio). All imaging features were correlated between them and with Ki-67 index. RESULTS: Forty-four of the 68 lesions (65%) were in the right lung. In MDCT, scan lesions appeared as a well-defined nodule in 44 patients (65%) and irregular mass in 24 patients (35%). Contrast intense enhancement was present in 53 patients (78%), calcifications in 20 patients (29%) and bronchial obstruction in 24 patients (35%). Lymph nodes and metastasis were present in 13 (19%) and 15 (22%) patients. Ki-67 index was negatively correlated with T/NT% and positively with SUV ratio; T/NT% and SUV ratio were inversely correlated. The presence of irregular margins and metastases was negatively related to T/NT%. The presence of a mass, irregular margins, bronchial obstruction, lymph nodes and metastasis was positively related to higher SUV ratio. The presence of irregular margins, bronchial obstruction, lymph nodes and metastases was significantly correlated with a higher grade of Ki-67 index. CONCLUSIONS: MDCT and nuclear molecular imaging are important to characterize lung TCs. The majority of TCs appear as a well-defined nodule generally not associated with extra-thorax signs. We found a significant correlation between some MDCT aspects, nuclear medicine features and Ki-67 index. The association of MDCT and nuclear medicine imaging may be useful in predicting proliferative activity and prognosis of lung TCs.


Assuntos
Tumor Carcinoide/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Tumor Carcinoide/patologia , Meios de Contraste , Feminino , Fluordesoxiglucose F18 , Humanos , Iohexol/análogos & derivados , Antígeno Ki-67/análise , Neoplasias Pulmonares/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Somatostatina/análogos & derivados
16.
Harefuah ; 159(1): 83-87, 2020 Feb.
Artigo em Hebraico | MEDLINE | ID: mdl-32048485

RESUMO

INTRODUCTION: The larynx is the most common site of neuroendocrine tumors in the head and neck region. Tumors are divided morphologically into epithelial-derived tumors (carcinomas) and neural-derived tumors (paragangliomas). The classification of neuroendocrine tumors has evolved over the past two decades. OBJECTIVES: To investigate the incidence and histological types of laryngeal tumors in Israel. To evaluate laryngeal neuroendocrine tumors treated at a single tertiary referral center, while describing current classification and controversies. METHODS: Retrospective investigation was conducted of laryngeal tumors treated at Hadassah University Hospital between the years 2007 and 2016. Analysis was performed of all cases diagnosed in Israel between 2005 and 2014. Previous and current classifications of laryngeal neuroendocrine tumors were reviewed. RESULTS: Two hundred and twenty new laryngeal cancers were diagnosed on average annually in Israel during the study period. Squamous cell carcinoma consisted in most cases (95%); yet, no documentation of neuroendocrine tumors was noted. Three patients, in their fifties, were treated for laryngeal neuroendocrine tumors at Hadassah. Tumors consisted of paraganglioma, typical carcinoid and small cell neuroendocrine carcinoma. Investigation, treatment, outcome, and classification are described. CONCLUSIONS: This is the first description of laryngeal neuroendocrine tumors in Israel. The lack of clarity for diagnosis, documentation and classification of this rare, heterogenic group of tumors, described worldwide, was noted in Israel as well. A multidisciplinary team, including experienced pathologists, radiologists, head and neck surgeons and oncologists, is mandatory for providing the best patient care.


Assuntos
Tumor Carcinoide , Neoplasias Laríngeas , Tumores Neuroendócrinos , Humanos , Israel , Estudos Retrospectivos
17.
Adv Exp Med Biol ; 1226: 87-95, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32030678

RESUMO

The pathological features of the appendix tumors fundamentally recall those of the more frequent colorectal neoplasms, although with a higher relative incidence of carcinoids, due to the abundant presence of enteroendocrine cells in the appendix wall. Moreover, different types of lymphomas, Hodgkin and non-Hodgkin, arising from the extra-nodal mucosal-associated lymphatic tissue, can be encountered. The appendix tumor microenvironment (TME) consists of a cellular component and of a noncellular component: the former includes the immunocompetent cells, while the latter represents the support stroma. Particularly in carcinoids, the immune cell reaction can be explicated by tumor-infiltrating lymphocytes, which, in some circumstances, may arrange around and inside the tumor in a brisk fashion influencing favorably the prognosis. This active reaction has to be distinguished from any preexisting inflammatory condition of the appendix and from superimposed tumor complications, such as infection or ischemia. In practice, we consider the appendix TME a complex framework with immunological, mechanic, and metabolic functions, all supported by a marked neo-lymphoangiogenesis.


Assuntos
Neoplasias do Apêndice , Microambiente Tumoral , Neoplasias do Apêndice/imunologia , Neoplasias do Apêndice/metabolismo , Neoplasias do Apêndice/patologia , Apêndice/imunologia , Apêndice/metabolismo , Apêndice/patologia , Tumor Carcinoide/imunologia , Tumor Carcinoide/metabolismo , Tumor Carcinoide/patologia , Humanos , Prognóstico
18.
Clin Imaging ; 62: 49-56, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32066033

RESUMO

PURPOSE: The purpose of this study was to determine whether the computed tomography (CT) features might be used in distinguishing pulmonary carcinoids from hamartomas. MATERIALS AND METHODS: Ninety solid pulmonary nodules (43 carcinoids and 47 hamartomas) in 90 patients were evaluated. The following CT scan features were evaluated: size, location (peripheral/central), contour (lobulated/nodular), number of lobulation, attenuation, calcification, endobronchial status, bronchial extension and involvement, parenchymal abnormalities distal to the lesion e.g. hyperlucency, atelectasis, and nodularity. The final pathologic diagnosis of the lesions and bronchial extension were confirmed by review of histopathological specimens. RESULTS: Out of 43 carcinoids, 37 (86%) were typical. Twenty-three carcinoids and four hamartomas were central (p < 0.001). Ten carcinoids and one hamartoma were endobronchial. The majority of tumors had lobulated contours (65% of carcinoids, 44% of hamartomas) and carcinoids tended to have more lobulations (p = 0.052). Distal nodularity (p = 0.001), distal hyperlucency (p < 0.001), and atelectasis (p = 0.005) were significantly more common in carcinoids. Carcinoids had significantly more bronchial extension and involvement (p < 0.001; respectively). In addition, a new sign that we call "bronchial triangle sign" differentiated carcinoids with a sensitivity and specificity of 84.9% (95% CI: 69,1%-93.4%) and 91% (95% CI: 79.7%-96.6%). CONCLUSION: To the best of our knowledge this is the first study on discrimination of carcinoids and hamartomas. A new CT sign called "bronchial triangle sign" might be used to differentiate carcinoids from hamartomas. Distal parenchymal abnormalities are more common in carcinoids than in hamartomas.


Assuntos
Neoplasias Brônquicas/diagnóstico por imagem , Tumor Carcinoide/diagnóstico por imagem , Hamartoma/diagnóstico por imagem , Adulto , Idoso , Brônquios/diagnóstico por imagem , Brônquios/patologia , Neoplasias Brônquicas/diagnóstico , Carcinoma Neuroendócrino , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atelectasia Pulmonar , Tomografia Computadorizada por Raios X/métodos
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