Pancreatic Metastasis of Thymic Neuroendocrine Carcinoma: Is There a Role for Endoscopic Ultrasound?

Varytimiadis, Konstantinos; Kalaitzakis, Evangelos; Salla, Charitini; Ghika, Efita; Pandazopoulou, Akrivi; Karoumpalis, Ioannis

doi:10.1097/mpa.0b013e3181816700

Cited by 9 publications

(5 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On US examination, metastases appear as solid hypoechogenic masses located within the pancreatic parenchyma [16]. Cysts are generally not a feature.…”

Section: Imaging Methods and Findingsmentioning

confidence: 99%

Metastatic disease to the pancreas: an imaging challenge

et al. 2011

View full text Add to dashboard Cite

Metastatic lesions of the pancreas are uncommon, accounting for approximately 2% of pancreatic malignancies. Many tumours involve the pancreas secondarily and may manifest with different clinical and imaging characteristics. Although many patients have widespread disease, isolated metastases can be found. Surgical management is associated with improved survival in these cases. The experience of the pancreatic surgery unit and imaging department of our hospital in many patients presenting with pancreatic metastases is presented, and a review of the recent literature is undertaken. Main Messages• The early recognition of secondary pancreatic tumours on US, CT and MRI is extremely important.• Pancreatic metastases may mimic primary pancreatic adenocarcinoma or induce acute pancreatitis.• Most pancreatic metastases are discovered on a CT examination performed for follow-up.

show abstract

“…On US examination, metastases appear as solid hypoechogenic masses located within the pancreatic parenchyma [16]. Cysts are generally not a feature.…”

Section: Imaging Methods and Findingsmentioning

confidence: 99%

Metastatic disease to the pancreas: an imaging challenge

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Indeed, this tumor was much larger than the other pancreatic NETs, grew very rapidly, in less than four months, while the other tumors were stable. Pancreatic metastasis of a thymic NET has been previously described in the literature (17). As found in the thymic NET, CDX2, ISL1, PAX8, TTF1 and GATA3 immunostaining was unexpectedly negative.…”

Section: Discussionmentioning

confidence: 54%

Early Detection of Relapse by ctDNA Sequencing in a Patient with Metastatic Thymic Tumor and MEN1 Mosaicism

Lagarde¹,

Collen

Boulagnon

et al. 2022

The Journal of Clinical Endocrinology &Amp; Metabolism

View full text Add to dashboard Cite

Context Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disease due to inactivating mutations in the MEN1 gene. In the literature, few cases of MEN1 have been reported due to mosaic MEN1 mutations. Objective: We performed an extensive molecular characterization in several lesions and blood samples, including plasmatic circulating cell-free DNA (ccfDNA) in an exceptional case of a patient with MEN1 mosaicism causing primary hyperparathyroidism, multiple pancreatic neuroendocrine tumors (NET), and a metastatic thymic NET. Design Blood, ccfDNA and multiple tissue analysis were performed by next generation sequencing. Results MEN1 mosaicism was confirmed by the multiple tissues analysis. The somatic analysis of the largest pancreatic NET revealed the same MEN1 second-hit mutation as found in thymic lesion, demonstrating its metastatic origin from thymic lesion. Moreover, in ccfDNA we found the mosaic MEN1 mutation but also the somatic second-hit mutation found in the thymic primary tumor, revealing the presence of circulating tumor DNA (ctDNA). After surgical removal of the pancreatic metastasis, the mutated fraction of both mutations decreased, before increasing again several weeks before a new clinical relapse, suggesting that thymic ctDNA may be used as an early tumor biomarker. Conclusion This exceptional MEN1 case highlighted (1) the importance of looking for MEN1 mosaicism (2) that MEN1 mosaicism can cause very aggressive disease, (3) the interest in analyzing ccfDNA for confirming MEN1 mosaicism but also a potential tumor biomarker for NET.

show abstract

“…About 20%-30% of patients with thymic AC experience local recurrence or distant metastasis [9]. Pancreatic metastasis of thymic NEC, including AC, is extremely infrequent, and in the literature, to the best of our knowledge, only 3 cases have been previously reported [10,11,12].…”

Section: Discussionmentioning

confidence: 99%

A Case of Distal Pancreatectomy for Pancreatic Metastasis of Thymic Atypical Carcinoid

Inoue¹,

Tanemura²,

Irei³

et al. 2017

AJMCR

View full text Add to dashboard Cite

Background: Thymic atypical carcinoid(AC) tends to have a more aggressive clinical course than typical carcinoid(TC). About 20%-30% of patients with thymic AC experience local recurrence or distant metastasis. Pancreatic metastasis of thymic AC is extremely infrequent. We experienced a case of pancreatic metastasis of thymic atypical carcinoid, in which a distal pancreatectomy was performed. Case presentation: A 50-year-old man underwent thoracoscopic resection of a mediastinal tumor in June 2009. The diagnosis was thymic AC. He also underwent an extended thymectomy in October 2011, thoracoscopic resection in October 2012, and tumor resection of the chest wall in March 2013 for recurrences. During follow up in April 2014, computed tomography (CT) revealed lymph node swelling on the ventral side of the brachiocephalic vein, around the left gastric vein, and on the left side of the celiac artery. Dynamic CT revealed a pancreatic tumor 10 mm in diameter with low enhancement. EUS-guided fine-needle aspiration (EUS-FNA) biopsy revealed the pancreatic tumor was compatible with metastasis of thymic AC. The patient underwent abdominal lymph node resection and distal pancreatectomy in June 2014. Because the lymph node on the ventral side of the branchiocephalic vein was judged as unresectable, 60-Gy radiation therapy was given in September 2014. Per pathological examination and immunohistochemistry, the final diagnosis was pancreatic metastasis of thymic AC. With several chemotherapy courses for recurrences, the patient has remained alive for eight years after the first surgery. Conclusion: AC metastasis to the pancreas is extremely rare. EUS-FNA is useful for diagnosis. Definitive determination of whether the treatment provides a survival benefit awaits further studies.

show abstract

Pancreatic Metastasis of Thymic Neuroendocrine Carcinoma: Is There a Role for Endoscopic Ultrasound?

Cited by 9 publications

References 9 publications

Metastatic disease to the pancreas: an imaging challenge

Metastatic disease to the pancreas: an imaging challenge

Early Detection of Relapse by ctDNA Sequencing in a Patient with Metastatic Thymic Tumor and MEN1 Mosaicism

A Case of Distal Pancreatectomy for Pancreatic Metastasis of Thymic Atypical Carcinoid

Contact Info

Product

Resources

About