Metastatic neuroendocrine tumor of the esophagus with features of medullary thyroid carcinoma

Fertig, Raymond; Alperstein, Adam; Díaz, Carlos Romero; Klingbeil, Kyle D.; Vangara, Sameera S; Misawa, Ryosuke; Reed, Jennifer; Gaudi, Sudeep

doi:10.5582/irdr.2017.01035

Cited by 5 publications

(4 citation statements)

References 19 publications

(19 reference statements)

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“…Hypersecretion of calcitonin by NENs is rare; in fact, in functional NENs, calcitonin secretion is less common than other hormone secretions causing endocrine paraneoplastic syndromes (79). Table 2 summarizes the main features of the calcitonin.-secreting NENs reported in the literature (1,5,7,40,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94). Pancreatic, laryngeal and lung NENs are most frequently associated with hypercalcitoninemia, but calcitonin secretion has also been described in duodenal, esophageal, cutaneous and paranasal NENs.…”

Section: False Positives and False Negativesmentioning

confidence: 99%

ENDOCRINE TUMOURS: Calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: the two-faced Janus

Giannetta

Guarnotta

Altieri

et al. 2020

European Journal of Endocrinology

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An increased calcitonin serum level is suggestive of a medullary thyroid cancer (MTC), but is not pathognomonic. The possibility of false positives or other calcitonin-secreting neuroendocrine neoplasms (NENs) should be considered. Serum calcitonin levels are generally assessed by immunoradiometric and chemiluminescent assays with high sensitivity and specificity; however, slightly-moderately elevated levels could be attributable to various confounding factors. Calcitonin values >100 pg/mL are strongly suspicious of malignancy, whereas in patients with moderately elevated values (10-100 pg/mL) a stimulation test may be applied to improve diagnostic accuracy. Although the standard protocol and the best gender-specific cut-offs for calcium stimulated calcitonin are still controversial, the fold of the calcitonin increase after stimulation seems to be more reliable. Patients with MTC show stimulated calcitonin values at least 3-4 times higher than the basal values, whereas calcitonin-secreting NENs can be distinguished from a C-cell disease by the absence of or <2-fold response to stimulation. The measurement of calcitonin in fine-needle aspirate washout (FNA-CT) and calcitonin immunocytochemical staining from thyroid nodules are ancillary methods that may significantly improve MTC diagnosis. The present review examines the gray areas in the interpretation of calcitonin measurement in order to provide a tool to clarify the origin of calcitonin secretion and differentiate the behavior of the two-faced Janus of neuroendocrinology: intra-thyroid (MTC) and extra-thyroid NENs.

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Section: False Positives and False Negativesmentioning

confidence: 99%

ENDOCRINE TUMOURS: Calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: the two-faced Janus

Giannetta

Guarnotta

Altieri

et al. 2020

European Journal of Endocrinology

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“…Neuroendocrine carcinoma often shows nested growth with prominent necrosis, and is positive for neuroendocrine markers, such as synaptophysin, chromogranin, and CD56. 35,36 Undifferentiated carcinoma shows no evident line of differentiation with negative immunohistochemistry for squamous, glandular, and neuroendocrine markers. Melanoma is generally positive for S100, SRY-box transcription factor 10, Mart-1, and HMB45, while negative for keratin.…”

Section: Squamous Cell Carcinomamentioning

confidence: 99%

Squamous Neoplasia in the Esophagus

Savant

Zhang

Yang

2020

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Squamous lesions of the esophagus encompass a spectrum of disorders ranging from reactive changes and benign papilloma to squamous dysplasia and squamous cell carcinoma, which may pose diagnostic challenges especially in superficial biopsies. Objective.— To provide a review on the typical features of squamous neoplasia in the esophagus, with an emphasis on the key diagnostic features as well as differential diagnosis from mimicking lesions. Data Sources.— Data sources include published peer-reviewed literature and personal experiences of the authors. Conclusions.— Accurate diagnosis of squamous neoplasia requires adherence to established diagnostic criteria, attention to subtle histologic features, and correlation with clinical and imaging findings. In difficult cases, multiple biopsies may be necessary to reach a definitive diagnosis.

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“…Therefore, accurate staging of the disease is essential. Although very limited cases of esophageal NET on 18 F-FDG PET/CT have been reported in the literature, 68 Ga-DOTATATE PET/CT findings of an esophageal NET has not been described before 9,10 . In this case, we present 68 Ga-DOTATATE PET/CT findings of an extremely rare case of a cervical esophageal NET.…”

mentioning

confidence: 77%