Digestive calcitonin-secreting tumors of the foregut: comparison with non-calcitonin-secreting tumors

Abstract

The secretion of calcitonin appears predictive of a poor prognosis. Digestive endocrine calcitonin-secreting tumors correspond histopathologically to poorly differentiated or well-differentiated carcinomas with high proliferation indexes.

Neuroendocrine tumors producing calcitonin: characteristics, prognosis and potential interest of calcitonin monitoring during follow-up

“…Clinical Study C Noziè res and others Calcitonin and neuroendocrine tumors 174:3of foregut NETs), 21 (12%) of 176 patients had serum CT concentrations O100 ng/l, which is in accordance with other studies: five (16%) of 32 foregut NETs in the Wuilmet's study (9) and six (9%) of 66 pancreatic NETs in the Fleury's study (3). However, this frequency depends: i) on the cut-off used to define 'high CT' (100 ng/l in our study, 20 ng/l in the Fleury study and 10 ng/l in the Wuilmet study), and ii) on the NET populations (NETs from various primaries in our study, whereas Wuilmet et al We show that high CT levels are predominantly met in NETs from foregut origin (pancreas and lung) and with high grades.…”

“…In the literature, there is a publication bias as most case reports are on patients with symptoms. However, in the two series of NETs patients with CT determination, including five and six patients with tumors secreting CT, only one (20%) and three (50%) had symptoms attributed to the peptide (diarrhea) (3,9). This is concordant with the fact that, in MTC, symptoms only occur in advanced metastatic forms with very high CT levels (18).…”

“…The trend is consistent with others studies. Wuilmet et al (9) reported that five of 32 patients with NETs and CT O10 ng/l were associated with poor prognosis. However, no multivariate analysis was performed in this small study and these five patients had a NET more often with poor differentiation, a high Ki67 and liver metastases, three well-known poor prognostic factors in NETs.…”

“…In fact, hypercalcitoninemia is not pathognomonic of MTC (2), and drugs, renal insufficiency, hyperparathyroidism or NETs could raise CT serum levels. However, CT-secreting NETs are rare, with few reports in the literature (3,4,5,6,7,8,9,10,11). A series of six cases of pancreatic origin showed that the tumors were often malignant, and that half the patients suffered from diarrhea (3).…”

“…A series of six cases of pancreatic origin showed that the tumors were often malignant, and that half the patients suffered from diarrhea (3). Another study reported that GEP-NETs with high CT had a worse prognosis than NETs with normal CT levels (9). Additional evaluation of CT-producing NETs may improve our understanding of the significance and interest of that inappropriate secretion.…”