Gastroenteropancreatic Neuroendocrine Tumors with Liver Metastases in Korea: A Clinicopathological Analysis of 72 Cases in a Single Institute

Shin, Yooju; Ha, Sang Yun; Hyeon, Ji-Yeon; Lee, Boram; Lee, Jeeyun; Jang, Kee Taek; Kim, Kyoung Mee; Park, Young Suk; Park, Cheol Keun

doi:10.4143/crt.2014.224

Cited by 11 publications

(14 citation statements)

References 22 publications

(35 reference statements)

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“…35.78% of all GI-NETs during the study period in our center have been from this location, and the most common primary site of liver metastasis has been the small intestine as well (39%). Most of the reports from other parts of Europe and the United States (US) have shown the same results; the most common site of GI-NET either with or without liver metastasis has been the small intestine (terminal ileum) ( 8 - 11 ); however, separate reports from other countries, such as Korea, have shown that most of the metastatic liver-NETs have originated from the pancreas ( 5 ).…”

Section: Discussionmentioning

confidence: 86%

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Liver Metastasis of Gastrointestinal Neuroendocrine Tumors: A Single Center Experience

2016

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Background: Gastrointestinal neuroendocrine tumors (GI-NETs) are potentially malignant tumors, and their most common location of metastasis is the liver. Objectives: In this report, we will describe our experience with some clinical and pathologic findings of hepatic metastasis in a group of cases of GI-NETs at the largest referral center of GI and liver diseases in south Iran. Materials and Methods:In this four-year study (2011 -2014), all GI and liver NETs were extracted from the pathology files of hospitals affiliated with Shiraz University of Medical Sciences. After classification based on the world health organization guidelines, the patients were evaluated according to their location, sex, age, and proliferative index. After studying the imaging and clinical charts of liver-NET cases with an unknown primary location, a complete panel of immunohistochemical markers (TTF-1, CDX-2, CK-7, CK-2, etc.) was used to find the primary GI location. Carcinoid tumors from other sites, such as the lung, were omitted from this study. Results:The most common primary site of metastatic GI-NET to the liver in our center was the small intestine, which was also the most frequent location of GI-NET without liver metastasis. No cases of appendiceal-NET were found with liver metastasis. In 8 cases (11.6%) with liver-NETs, no primary location was identified. GI-NETs with liver metastasis had a significantly higher grade and proliferative index compared with NETs without liver metastasis. Conclusions: Liver metastasis of neuroendocrine tumors in Iran presents in a very similar manner as that seen in western countries. In about 89% of cases with liver-NET, complete imaging, clinical, and pathological studies can help to identify the primary origin of the liver-NET, which is very important in the patient's management.

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Section: Discussionmentioning

confidence: 86%

“…The most common metastatic site of involvement in this group of tumors is the liver ( 4 ). There are different reports from several parts of the world about the primary sites of GI-NET involving the liver ( 5 - 7 ). However, no study has been published in Iran about the epidemiology of GI-NETs with hepatic involvement so far.…”

Section: Discussionmentioning

confidence: 99%

Liver Metastasis of Gastrointestinal Neuroendocrine Tumors: A Single Center Experience

2016

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“…Male predilection has been shown in both metastatic and primary neuroendocrine tumors by Shen et al[26] and Shin et al[22] in their studies. However, some studies have reported almost similar incidence in males and females[2,5,17,20,27-29].…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have also reported that pancreas to be the most common primary site followed by rectum, stomach and ileum amongst the GEP NEN metastasizing to liver[20-22]. Begum et al[23] have shown that in their study of 2009 cases of GEP NEN, pancreas was the most common site accounting for 34.2% of cases followed by midgut (5.8%), gastric (6.5%), colon (6.9%) and duodenum (4.8%).…”

Section: Discussionmentioning

confidence: 99%

Neuroendocrine neoplasms of liver - A 5-year retrospective clinico-pathological study applying World Health Organization 2010 classification

Burad¹,

Kodiatte²,

Rajeeb³

et al. 2016

WJG

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AIMTo study the clinicopathological characteristics of neuroendocrine neoplasms (NEN) on liver samples and apply World Health Organization (WHO) 2010 grading of gastroenteropancreatic (GEP) NEN.METHODSClinicopathological features of 79 cases of NEN of the liver diagnosed between January 2011 to December 2015 were analyzed. WHO 2010 classification of GEP NEN was applied and the tumors were graded as G1, G2 or G3. Two more categories, D1/2 (discordant 1/2) and D2/3 (discordant 2/3) were also applied. The D1/2 grade tumors had a mitotic count of G1 and Ki-67 index of G2. The D2/3 tumors had a mitotic count of G2 and Ki-67 index of G3. The follow up details which were available till the end of the study period (December 2015) were collected.RESULTSOf the 79 tumors, 16 each were G1 and G2, and 18 were G3 tumors. Of the remaining 29 tumors, 13 were assigned to D1/2 and 16 were D2/3 grade. Male preponderance was noted in all tumors except for G2 neoplasms, which showed a slight female predilection. The median age at presentation was 47 years (range 10-82 years). The most common presentation was abdominal pain (81%). Pancreas (49%) was the most common site of primary followed by gastrointestinal tract (24.4%) and lungs (18%). Radiologically, 87% of the patients had multiple liver lesions. Histopathologically, necrosis was seen in only D2/3 and G3 tumors. Microvascular invasion was seen in all grades. Metastasis occurred in all grades of primary NEN and the grades of the metastatic tumors and their corresponding primary tumors were similar in 67% of the cases. Of the 79 patients, 36 had at least one follow up visit with a median duration of follow up of 8.5 mo (range: 1-50 mo). This study did not show any impact of the grade of tumor on the short term clinical outcome of these patients.CONCLUSIONLiver biopsy is an important tool for clinicopathological characterization and grading of NEN, especially when the primary is not identified. Eighty-seven percent of the patients had multifocal liver lesions irrespective of the WHO grade, indicating a higher stage of disease at presentation. Follow up duration was inadequate to derive any meaningful conclusion on long term outcome in our study patients.

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“…Our patient with gastric NET G2 developed liver metastasis 11 months after gastrectomy. Shin et al reported that one of eight patients who have gastric NET with liver metastases was G2 and others were NEC (15). Another factor, like unknown primary tumor as reported (15), other than histological grade may affect the prognosis.…”

Section: Discussionmentioning

confidence: 99%

Unusual endoscopic findings of gastric neuroendocrine tumor

et al. 2015

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Gastroenteropancreatic Neuroendocrine Tumors with Liver Metastases in Korea: A Clinicopathological Analysis of 72 Cases in a Single Institute

Cited by 11 publications

References 22 publications

Liver Metastasis of Gastrointestinal Neuroendocrine Tumors: A Single Center Experience

Liver Metastasis of Gastrointestinal Neuroendocrine Tumors: A Single Center Experience

Neuroendocrine neoplasms of liver - A 5-year retrospective clinico-pathological study applying World Health Organization 2010 classification

Unusual endoscopic findings of gastric neuroendocrine tumor

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