Poorly differentiated small cell neuroendocrine carcinoma localized in three different endocrine glands: Response to chemotherapy and octreotide LAR(328 views) Tauchmanovà L, Pensabene M, Capuano I, Spagnoletti I, Zeppa P, Del Vecchio S, Mainenti PP, De Rosa G, Colao A, Contegiacomo A
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, Naples, Italy
Department of Anatomical Pathology and Cytology, Federico II University of Naples, Naples, Italy
Department of Biomorphological and Functional Sciences, Federico II University of Naples, Naples, Italy
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Levi, F., Te, V. C., Randimbision, L., Rindi, G., La Vecchia, C., Epidemiology of carcinoid neoplasms in Vaud, Switzerland, 1974-97 (2000) Br J Cancer, 83, pp. 952-955
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Vortmeyer, A. O., Lubensky, I. A., Erino, M. J., Concordance of genetic alterations in poorly differentiated colorectal neuroendocrine carcinomas and associated adenocarcinomas (1997) J Nat Cancer Lnst, 89, pp. 1448-1453
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Kaltsas, G. A., Mukherjee, J. J., Gossman, A. B., The value of radiolabelled MIBG and octreotide in the diagnosis and management of neuroendocrine tumors (2001) Ann Oncol, 12 (SUPPL. 2), pp. S47-S50
Kaltsas, G. A., Bessere, M., Grossman, A. B., The diagnosis and medical management of advanced neuroendocrine tumors (2004) Endocr Rev, 25, pp. 458-511
Agarwal, S. K., Kester, M. B., Debelenko, L. V., Germline mutations of the MEN1 gene in familial multiple endocrine neoplasia type 1 and related states (1997) Hum Mol Genet, 6, pp. 1169-1175
Debelenko, L. V., Swalwell, Jl., Kelley, M. J., MEN 1 gene mutation analysis of high-grade neuroendocrine lung carcinoma (2000) Genes Chromosomes Cancer, 28, pp. 58-65
Hainsworth, H. D., Johnson, D. H., Greco, F. A., Poorly differentiated neuroendocrine carcinoma of unknown primary site: A newly recognized clinicopathologic entity (1988) Ann Int Med, 109, pp. 364-371
Barakat, M. T., Meeran, K., Bloom, S. R., Neuroendocrine tumors (2004) Endocr Relat Cancer, 11, pp. 1-18
Norton, J. A., Fraker, D. L., Alexander, H. R., Surgery to cure the Zollinger-Ellison syndrome (1999) N Engl J Med, 341, pp. 635-644
Moertel, C. G., Knolsk, L. K., O'Connell, M. J., Rubin, J., Treatment of neuroendocrine carcinomas with combined etoposide and cisplatin. Evidence of major therapeutic activity in the anaplastic variants of these neoplasms (1991) Cancer, 68, pp. 227-232
Fjallskog, M. L., Granberg, D. P., Welin, S. L., Treatment with cisplatin and etoposide in patients with neuroendocrine tumors (2001) Cancer, 92, pp. 1101-1107
Lamberts, S. W. J., Krenning, E. P., Reubi, J. C., The role of somatostatin and its analogs in the diagnosis and treatment of tumors (1991) Endocr Rev, 12, pp. 450-482
Kwekkeboom, D. J., Krenning, E. P., Somatostatin receptors imaging (2002) The Expanding Role of Octreotide I: Advances in Oncology, pp. 17-30. , SWJ Lamberts and L Dogliotti eds. Bristol: BioScientifica Ltd
Dejong, C. H., Parks, R. W., Currie, E., Piris, J., Redhead, D. N., Garden, O. J., Treatment of hepatic metastases of neuroendocrine malignancies: A 10-year experience (2002) J R Coll Surg Edinb, 47, pp. 495-499
Poorly differentiated small cell neuroendocrine carcinoma localized in three different endocrine glands: Response to chemotherapy and octreotide LAR
Neuroendocrine tumors represent a heterogeneous category of neoplasm, with conflicting diagnostic and therapeutic demands. We here describe the case of a 72-yr-old woman with evidence of a poorly differentiated small-cell neuroendocrine carcinoma (NEC) localized in different endocrine glands and other non-endocrine organs. In particular, a large ovarian mass, multinodular thyroid goiter, right adrenal mass, cystic liver metastases and anterior mediastinum lymph node metastasis were present. The largest thyroid nodule caused tracheal restriction and dyspnea. Diagnosis of poorly differentiated metastasized NEC of unknown origin was made on the basis of histological and immunohistochemical findings, and treatment with etoposide (1100 mg/m(2) in days 1, 2 and 3) and cisplatinum (45 mg/m(2) in days 2 and 3) was initiated. Simultaneously, im administration of octreotide LAR 20 mg every 28 days was started, according to the presence of SS receptors at In-111-octreotide scan. Rapid improvement of dyspnea and a reduction of the largest thyroid nodule, liver metastases and adrenal mass by 50% were observed after 3 months of treatment; the dimensions remained stable thereafter, while the pericardial lymph node disappeared. In conclusion, poorly differentiated NEC of unknown primary site is a well-recognized category, usually with an aggressive behavior, rapid growth rate and wide dissemination. Median survival of these patients is 6 months if left untreated. Our patient is alive 18 months after beginning the treatment, reporting good general condition and quality of life over the whole follow-up period. (c) 2005, Editrice Kurtis.
Poorly differentiated small cell neuroendocrine carcinoma localized in three different endocrine glands: Response to chemotherapy and octreotide LAR