Bone metastases in neuroendocrine tumors

Abstract

Neuroendocrine tumors arise from various cells that form a part of the endocrine system and account for a small number of cases encountered by oncologists in clinical practice. The clinical incidence of these tumors used to be low, and newer imaging modalities have now begun to be used for detecting bone metastases at an earlier stage. Bone metastases arising from neuroendocrine tumors are a well-recognized complication. Their presence carries along a poor prognosis. Clinical symptoms are similar to those encountered in other forms of cancer that are complicated by bone metastasis. Over the last decade or so, the clinical detection, diagnostic methods and treatment strategies have changed dramatically, and new treatments are emerging slowly. The indolent course of neuroendocrine tumors and the development of bone metastasis have limited our current knowledge on how to best prevent and manage the condition. Current information available from clinical studies is marred by paucity and small sample sizes, making further clinical trials an absolute necessity. In this review, we discuss the current status in the diagnosis and management of bone metastases arising from neuroendocrine tumors (Fig. 3, Ref. 28).

Rare Case of High Grade Neuroendocrine Carcinoma Found on Bone Marrow Biopsy: A Case Report

“…Of note, it has been suggested that hypercalcemia is a rare finding in bone metastases secondary to NETs, with only 4% of cases being reported; hypercalcemia is more commonly associated with pheochromocytomas or sympathetic paragangliomas, compared to gastropancreatic carcinomas. 8 Another study revealed that 44–73% of patients with NETs present with metastatic disease, and bone involvement is likely underestimated and oftentimes found post-mortem. 9 …”

Neuroendocrine neoplasia and bone (Review)

“…NENs may affect the skeleton status through different mechanisms (23,24). On the one hand, there are well-established malignancy-related aspects which include: bone metastases potentially associated with pathological fractures (such as vertebral fractures or even atypical femoral fractures), vertebral/cord compression due to vertebral fractures, and paraneoplasic hypercalcemia (23,24).…”

“…NENs may affect the skeleton status through different mechanisms (23,24). On the one hand, there are well-established malignancy-related aspects which include: bone metastases potentially associated with pathological fractures (such as vertebral fractures or even atypical femoral fractures), vertebral/cord compression due to vertebral fractures, and paraneoplasic hypercalcemia (23,24). The natural history of such incidental events largely varies due to the multiple subtypes of NENs; thus, a different behavior is expected, but the most important aspect in secondary dissemination is actually the tumor aggressive pattern rather than a particular histological type (25,26).…”

“…Generally, the presence of bone metastases in patients with NENs is regarded as a poor prognostic indicator and the local behavior typically does not differ in regards to the bone metastases of other non-NEN malignancies (23). If liver and lung metastases are already identified, then skeleton and brain metastases should be checked (27).…”

Kemiğe nadir metastaz yapan tümörler

“…Kemik sintigrafisinde tespit edilen lezyonların direkt grafiyle incelenmesi ve kombine yaklaşımlarla, metastazların tespitinde ve tedavinin takibinde güvenilirlik artmıştır. [6] BT ve MR, direkt grafi ile de doğrulanan şüpheli kemik sintigrafi bulgularının değerlendirilmesinde çok etkindir. MR aynı zamanda, kemik metastazlarının kemikte sintigrafik olarak gösterilebilecek lezyonlarının metabolik değişiklik yapmadan önce görüntülenmesini sağladığından, çok değerli bir yöntem olarak kabul edilir.…”