Imaging in a rare case of neuroendocrine tumour with skin metastases

Białecki, Marcin; Białecka, Agnieszka; Męcińska-Jundziłł, Kaja; Adamska, Urszula; Kasperska, Anna; Czajkowski, Rafał

doi:10.5114/pjr.2018.73307

Cited by 3 publications

(1 citation statement)

References 15 publications

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“…Cases of skin (cutaneous/subcutaneous) metastases derived from neuroendocrine tumors of the lung [3][4][5][6][7][8], gastrointestinal [2,[9][10][11] and genitourinary tract [12][13][14][15] as well as of other origins or with unknown primary tumor site [16][17][18] have been exceptionally reported. In line with observations and revisions by Amorim et Al.…”

Section: Discussionmentioning

confidence: 99%

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Ciliberti¹,

Carbonara

Grillo³

et al. 2020

BMC Cancer

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Background: Skin metastases from pancreatic neuroendocrine carcinoma (PNEC) are rare and their palliative treatment is challenging. We report our experience in the multimodal management of one of the few reported cases of metastatic PNEC with multiple visceral and subcutaneous secondary lesions, focusing on the effectiveness of palliative radiotherapy for skin metastases. Case presentation: A 61-years old woman affected by a metastatic PNECwith subcutaneous growing and bleeding secondary lesions (at the scalp, right scapular region and at the back of the left thoracic wall, respectively) obtained a successful control of visceral metastases with the use of chemotherapy and an unexpected local response of her skin metastases with palliative radiotherapy. In particular, two subsequent radiation treatments were performed using different fractionation schedules (30 Gy in 10 fractions and 20 Gy in 5 fractions, respectively). Both radiation treatments were well-tolerated and patient's quality of life was improved. Local response was maintained until patient's deaththat occurred due to cachexia. Conclusions: The presented case highlights the effectiveness and the good tolerance of radiotherapy in the treatment of subcutaneous metastases; nevertheless, further knowledge of the optimal local palliative approach for PNEC metastatic sites is necessary. The experience gained in this work is the occasion to encourage a routine integrated multidisciplinary team management of metastatic PNECs because of their clinical complexity. The aim is to guarantee the optimization of the care with personalized and more effective systemic and local treatmentsalso including supportive cares and treatment-related side effects management.

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Section: Discussionmentioning

confidence: 99%

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Ciliberti¹,

Carbonara

Grillo³

et al. 2020

BMC Cancer

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Poorly differentiated neuroendocrine rectal carcinoma with uncommon immune-histochemical features and clinical presentation with a subcutaneous metastasis, treated with first line intensive triplet chemotherapy plus bevacizumab FIr-B/FOx regimen: an experience of multidisciplinary management in clinical practice

et al. 2019

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BackgroundNeuroendocrine tumors (NETs) are heterogeneous, widely distributed tumors arising from neuroendocrine cells. Gastrointestinal (GI)-NETs are the most common and NETs of the rectum represent 15, 2% of gastrointestinal malignancies. Poorly differentiated neuroendocrine carcinomas of the GI tract are uncommon. We report a rare case of poorly differentiated locally advanced rectal neuroendocrine carcinoma with nodal and a subcutaneous metastasis, with a cytoplasmic staining positive for Synaptophysin and Thyroid Transcription Factor-1.Case presentationA 72-year-old male presented to hospital, due to lumbar, abdominal, perineal pain, and severe constipation. A whole-body computed tomography scan showed a mass of the right lateral wall of the rectum, determining significant reduction of lumen caliber. It also showed a subcutaneous metastasis of the posterior abdominal wall. Patient underwent a multidisciplinary evaluation, diagnostic and therapeutic plan was shared and defined. The pathological examination of rectal biopsy and subcutaneous nodule revealed features consistent with small-cell poorly differentiated neuroendocrine carcinoma. First line medical treatment with triplet chemotherapy and bevacizumab, according to FIr-B/FOx intensive regimen, administered for the first time in this young elderly patient affected by metastatic rectal NEC was highly active and tolerable, as previously reported in metastatic colo-rectal carcinoma (MCRC). A consistent rapid improvement in clinical conditions were observed during treatment. After 6 cycles of treatment, CT scan and endoscopic evaluation showed clinical complete response of rectal mass and lymph nodes; patient underwent curative surgery confirming the pathologic complete response at PFS 9 months.Discussion and conclusionsThis case report of a locally advanced rectal NEC with an unusual subcutaneous metastasis deserves further investigation of triplet chemotherapy-based intensive regimens in metastatic GEP NEC.

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Skin Metastases of Gastrointestinal Neuroendocrine Tumors – Literature Review

2022

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Introduction: Gastrointestinal neuroendocrine neoplasms arise from cells of a diffuse endocrine system (DES) located in the digestive tract. They are often diagnosed in an advanced stage, when distant metastases appear. Skin metastases of the neuroendocrine tumors are extremely rare. Material and methods: Literature search across PubMed and Medline databases from 1969 up to 2021 was performed. We reviewed English literature according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The following keywords were used: neuroendocrine tumor, neuroendocrine neoplasm, neuroendocrine carcinoma, NET, NEN, skin and cutaneous metastases, lymph nodes. Characteristics of patients, grading, tumor localization and other data that was found in publications were assessed. Case reports and case series were included. Results: The initial search strategy yielded 14 results in PubMed and 3 in Medline database. We removed the duplicates after we have imported the citations with a citation manager. We found 17 publications of the skin metastases of neuroendocrine neoplasms. The analysis of 18 cases concerned 13 NECs and 5 NETs. Conclusion: In most cases, the metastases are small, painless and located on the scalp or lower limbs. Skin metastases may be the first symptom of the disease. The pancreas is the most common primary tumor site. Discussion: NEN metastases to the skin are often diagnosed with disseminated neoplastic process, which is associated with poor prognosis and high mortality. NET metastases to the skin may occur with an unknown primary site. Skin metastases of neuroendocrine tumors should be considered during the diagnosis process of skin tumors. Key words: neuroendocrine tumor, digestive tract, metastases, skin

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Imaging in a rare case of neuroendocrine tumour with skin metastases

Cited by 3 publications

References 15 publications

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Unexpected response to palliative radiotherapy for subcutaneous metastases of an advanced small cell pancreatic neuroendocrine carcinoma: a case report of two different radiation schedules

Skin Metastases of Gastrointestinal Neuroendocrine Tumors – Literature Review

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