Cystic pancreatic endocrine tumors

Charfi, Slim; Marcy, M.; Bories, Erwan; Pesanti, Christian; Caillol, Fabrice; Giovannini, Marc; Viret, F.; Delpero, Jean‐Robert; Xerri, Luc; Monges, Geneviève

doi:10.1002/cncy.20024

Cited by 17 publications

(6 citation statements)

References 32 publications

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“…Other treatment options include radiofrequency ablation, chemoembolisation, radioembolisation, palliative surgery (eg debulking), systemic chemotherapy (for high grade tumours) and medical therapy (eg somatostatin analogues) to reduce symptoms in functional tumours. 4,8,9 It is essential that tumours are graded accurately at initial diagnosis to ensure that patients with low grade tumours are not put through unnecessary treatments, that those with aggressive disease are not undertreated 24 and that those for whom curative therapy exists, receive it.…”

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confidence: 99%

Correlation of Ki-67 indices from biopsy and resection specimens of neuroendocrine tumours

Barnes

Johnson

French

2017

annals

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INTRODUCTION Neuroendocrine tumours (NETs) are a heterogeneous group of tumours with a highly variable presentation and prognosis. Management decisions are complex. Ki-67 levels in tissue samples are a key indicator used to grade tumours and guide treatment. This study assessed whether the Ki-67 index and tumour grade generated from tissue samples correlated with that assessed in resection specimens. METHODS This was a retrospective cohort analysis of all patients who had both a tissue sample and a resection specimen analysed in our trust, a tertiary referral centre, during 2012 and 2013. RESULTS Data from 36 patients were reviewed. Ki-67 indices from tissue samples and resection specimens showed strong correlation (r=0.95, p<0.001). Tumour grading was the same in the tissue sample and resection specimens for 22 patients (61.1%). In four patients (11.1%), the tissue sample overestimated the grade while in ten (27.8%), the sample underestimated the grade. CONCLUSIONS In most cases, the Ki-67 index and tumour grade from the tissue sample matched that of the resection specimen. However, in nearly 40% of cases, the tissue sample grading did not match the resection tumour grading. In the majority of these, the tissue sample underestimated disease activity. A low Ki-67 index in a tissue sample should therefore be taken as provisional and should not, in isolation, persuade clinicians to choose a more conservative treatment approach if there is clinical, biochemical or radiological evidence suggestive of a more aggressive disease pathology.

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confidence: 99%

Correlation of Ki-67 indices from biopsy and resection specimens of neuroendocrine tumours

Barnes

Johnson

French

2017

annals

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“…In our patient, the cyst fluid levels of carcinoembryonic antigen were normal. Elevated levels of carcinoembryonic antigen in cysts are a useful marker of mucinous cysts [13,14] and it is therefore interesting to note that numerous previous studies have reported that cyst fluid levels of carcinoembryonic antigen are usually low in cystic neuroendocrine tumors [15,16]. …”

Section: Discussionmentioning

confidence: 99%

Cystic neuroendocrine tumor in the pancreas detected by endoscopic ultrasound and fine-needle aspiration: a case report

et al. 2014

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BackgroundPancreatic neuroendocrine tumors are typically solid neoplasms but in very rare cases present as cystic lesions. The diagnosis of cystic tumors in the pancreas is extremely difficult and the use of endoscopic ultrasound and fine-needle aspiration might be helpful in the work-up of patients with cystic neuroendocrine tumors in the pancreas.Case presentationA 78-year-old Caucasian man was admitted with a history of epigastric pain. Laboratory tests were normal. The patient underwent transabdominal ultrasound, computed tomography and magnetic resonance cholangiopancreatography demonstrating an unclear cystic mass in the head of the pancreas. The patient was referred for endoscopic ultrasound. Endoscopic ultrasound showed a hypoechoic lesion (42 × 47 mm) in the head of the pancreas with regular borders and large cystic components. The main pancreatic duct was normal without any connection to the cystic process. The lesion underwent fine-needle aspiration (22 Gauge). Cytological examination demonstrated cohesive groups of plasmacytoid cells staining positively for synaptophysin and chromogranin A, which is suggestive of a neuroendocrine tumor.ConclusionsDifferential diagnosis of cystic lesions in the pancreas is very difficult with conventional radiology, such as computed tomography and magnetic resonance imaging. This unusual case with a pancreatic cystic neuroendocrine tumor highlights the clinical importance of endoscopic ultrasound in the work-up of patients with unclear lesions in the pancreas.

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“…Imaging is unable to reliably differentiate cystic-NETs from other PCLs as well as simple cysts, pseudocysts or SCAs [ 77 , 82 ]. Thus, EUS with fine needle aspiration and immunostaining has been suggested as a more effective modality for diagnosing cystic-NETs [ 77 , 83 ].…”

Section: Cystic Neuroendocrine Tumors (Cystic-net)mentioning

confidence: 99%

“…Cystic-NETs have been shown to stain positive for synaptophysin and chromogranin [ 75 , 77 , 79 , 83 , 84 ]. This staining helps distinguish Cystic-NETs from other PCLs that may have similar histological or immunohistochemical features.…”

Section: Cystic Neuroendocrine Tumors (Cystic-net)mentioning

confidence: 99%

“…Furthermore, MEN1 associated cystic-NETs have been demonstrated to be multiple, in the tail and functioning [ 79 ]. However, the majority of studies have not found this association, suggesting cystic-NETs are sporadic, being larger than and resulting from cystic degeneration of solid, non-cystic pancreatic neuroendocrine tumors [ 75 , 82 , 83 , 84 , 87 ].…”

Section: Cystic Neuroendocrine Tumors (Cystic-net)mentioning

confidence: 99%

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Pancreatic Cystic Lesions: Pathogenesis and Malignant Potential

Pusateri

Krishna

2018

Diseases

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Pancreatic cancer remains one of the most lethal cancers despite extensive research. Further understanding of precursor lesions may enhance the ability to treat and prevent pancreatic cancer. Pancreatic cystic lesions (PCLs) with malignant potential include: mucinous PCLs (intraductal papillary mucinous neoplasms and mucinous cystic neoplasm), solid pseudopapillary tumors and cystic neuroendocrine tumors. This review summarizes the latest literature describing what is known about the pathogenesis and malignant potential of these PCLs, including unique epidemiological, radiological, histological, genetic and molecular characteristics.

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Cystic pancreatic endocrine tumors

Cited by 17 publications

References 32 publications

Correlation of Ki-67 indices from biopsy and resection specimens of neuroendocrine tumours

Correlation of Ki-67 indices from biopsy and resection specimens of neuroendocrine tumours

Cystic neuroendocrine tumor in the pancreas detected by endoscopic ultrasound and fine-needle aspiration: a case report

Pancreatic Cystic Lesions: Pathogenesis and Malignant Potential

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