Anatomic and Functional Imaging of Metastatic Carcinoid Tumors

Scarsbrook, Andrew; Ganeshan, Arul; Statham, J.; Thakker, Rajesh V.; Weaver, Andrew J.; Talbot, Denis; Boardman, Philip; Bradley, Kevin M.; Gleeson, Fergus; Phillips, Rachel R.

doi:10.1148/rg.272065058

Cited by 96 publications

(73 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Their exact origin is unknown with literature suggesting origination from ectopic pancreatic or adrenal tissue in the liver or intestinal metaplasia of intrahepatic neuroendocrine cells (1). Neuroendocrine tumors most commonly originate in the gastrointestinal system, mostly in the appendix or small bowel (2,4). Less commonly they may be seen in the bronchopulmonary system, pancreas and genitals as well.…”

Section: Discussionmentioning

confidence: 99%

A rare case of a primary hepatic neuroendocrine tumor

Sethi

Kulkarni

2016

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

A rare case of a primary hepatic neuroendocrine tumor

Sethi

Kulkarni

2016

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

“…1 Carcinoid tumors derives from enterochromaffin cells also known as Kulchitsky cells which are distributed everywhere around the human body. 2 This cell population is mostly predominant along the gastro intestinal tract, in the urogenital tract and lungs specifically as part of the bronchial epithelium. 3 The diagnosis of this type of tumors is different in each individual depending on the embryologic origin of the tumor, which could show different clinical manifestations, blood chemical parameters and distinctive morphology and histology.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 The exact reason for this increase is not well understood, however, it might be related to increase of awareness among trained physicians as well as better diagnosis tools and available treatments. 2 The etiology of carcinoid tumors remains unknown however, with the molecular advances the literature reports shown a non-relationship with the common oncogenes such as ras, myc, fos, jun and src as well with the tumor suppressor genes p53 and retinoblastoma except in the more atypical forms. 3 The localization in general is predictable due to the common rising in some blood chemistry test; all of them have the capability to produce a hormonal misbalance sharing the blood elevation of chromogranin A (CgA) as a common point.…”

Section: Discussionmentioning

confidence: 99%

“…3 The localization in general is predictable due to the common rising in some blood chemistry test; all of them have the capability to produce a hormonal misbalance sharing the blood elevation of chromogranin A (CgA) as a common point. 2 According to this evidence the presentation and findings can change based on the embryonic origin of the tumor; the foregut lesions account for 20-25% of all carcinoid tumors in which normally the primary lesions are found in the lung, thymus, stomach, or proximal duodenum with few cases along the hepatobiliary tract or pancreas. 7 There are usually associated with low serotonin levels but also they are able to produce serotonin precursors, histamine, corticotropin releasing hormone, adrenocorticotropic hormone (ACTH), gastrin, and CgA.…”

Section: Discussionmentioning

confidence: 99%

“…4 Hindgut tumors mainly secrete hormones like pancreatic polypeptide, somatostatin, and chromogranin A. 2 As a diagnostic instrument, tumor serum markers represent an essential mechanism to make the diagnosis, playing an important role as a prognostic factor or as a control to evaluate the treatment response. 8,9 These serum markers are a heterogeneous group of molecules that normally are present in small blood concentrations in healthy individuals.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Non oncologic elevated levels of chromogranin A in a symptomatic patient without a carcinoid tumor

2013

View full text Add to dashboard Cite

The diagnosis of neuroendocrine tumors requires a highly suspicious level due to its variable symptoms and clinical presentation. Early diagnosis, prompt and appropriate treatments are clues to success preventing the eventual disease progression and the devastating consequences of the carcinoid syndrome. Measurement of the chromogranin A, plays an important role in the diagnosis of carcinoid tumors, during the clinical evolution and even more to evaluate the treatment response to somatostatin analogues. However, in some situations like our case, the serum levels evaluation could be a confounding factor imitating the clinical scenario of the disease especially when the chromogranin level is elevated but not in the typical oncologic range and moreover when the symptoms magnitude is really convincing and similar to the tumor disease instances. Case ReportA 58-year-old Hispanic woman with non-past medical history and negative history of risk factors presented to the emergency department with one-day history of lower extremity edema, shortness of breath and tachycardia. She has a history of mammary prosthesis replacement 28 days ago. An initial diagnosis of pulmonary embolism was made; a pulmonary angio computed tomography (CT) was performed showing no vascular occlusion. Transthoracic echocardiogram has shown normal EF of 60% and no valvular disease. Coronary pharmacologic perfusion echocardiogram showed normal heart function and finally renal function was normal. The patient was treated for acute heart failure and discharged with ambulatory control. Six months later, upper gastric endoscopy was performed evidencing multiple polyps. Immediately after the procedure, the patient presented an episode of upper body flushing and an intense diffuse dull abdominal pain without rebound and tenderness. She concern that she had experienced explosive episodes of non bloody diarrhea, self limited episodes of dry cough, frequent episodes of flushing in the upper trunk and face with profuse sweating and intense pruritus lasting 15 minutes associated with significant unintentional weight loss over the last 6 month. Further workup included negative brain MRI, negative chest CT and abdominal MRI that only showed multiple benign liver cysts, (Figure 1) pancreatic and rectal endosonography were also normal. Somatostatin receptor scintigraphy (SRS) with Indium-111-DPA-octreotide was negative, capsule endoscopy negative for masses, 24-hour urine level of 5-HIAA appeared borderline 9.8 mg/24 hr (range levels 1.9-10.0 mg/24 hr) and plasma chromogranin A were above the reference range 92.0 ng/mL (range levels 1.9-15.0 ng/mL by electrochemilumiscent method) ( Table 1). An endoscopic polypectomy was done and histopathology reported hyperplasic polyps. Three months later, due to the persistent and more intense symptoms, a SRS with Indium-111-DPA-octreotide was repeated showing positive reactivity at the epigastric area and chromogranin A control persists elevated. The patient was placed on monthly intramuscular octreotide with dramati...

show abstract

Imaging of Rare Gynecologic Tumors

Prabhakar

Perera

2014

Uncommon Gynecologic Cancers

View full text Add to dashboard Cite

Anatomic and Functional Imaging of Metastatic Carcinoid Tumors

Cited by 96 publications

References 65 publications

A rare case of a primary hepatic neuroendocrine tumor

A rare case of a primary hepatic neuroendocrine tumor

Non oncologic elevated levels of chromogranin A in a symptomatic patient without a carcinoid tumor

Imaging of Rare Gynecologic Tumors

Contact Info

Product

Resources

About