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Primary testicular neuroendocrine tumor with liver lymph node metastasis: A case report and review of the literature

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World Journal of Clinical Cases 2022年第32期10卷 12028-12035页

作者： Tong Xiao Long-Hua Luo Liang-Fei Guo Li-Qin Wang Liang Feng Department of Urology The First Affiliated Hospital of Nanchang UniversityNanchang 330006Jiangxi ProvinceChina.

BACKGROUND Primary testicular neuroendocrine tumors(TNETs)are sporadic,accounting for only 0.23%of all testicular tumors.Few cases have been reported in the literature,and no uniform treatment protocol exists.We report a case of a primary TNET with liver lymph node metastasis diagnosed at the age of 24 years and discuss its clinicopathological features,diagnosis,differential diagnosis,treatment,and prognosis.CASE SUMMARY We report the case of a 24-year-old patient with a primary TNET with liver lymph node metastasis.The patient was found to have a right testicular swelling of about 3 cm×4 cm in size with unclear borders and no testicular pressure pain seven years ago without any examination or treatment.One month ago,an ultrasound examination was performed for persistent enlargement of the right testis,which showed an occupying lesion of the right testis approximately 110 mm×102 mm×82 mm in size.Magnetic resonance imaging scan of the testis(plain scan)showed that the right testis was an occupying lesion with inhomogeneous density and mixed signal,the boundary was still clear,and the possibility of seminoma was considered;chest X-ray and computed tomography did not show any apparent abnormalities.The patient underwent radical orchiectomy,and the pathological examination suggested a right TNET with a typical carcinoid tumor histological type.One month after the surgery,the patient received nine cycles of lanreotide chemotherapy at a dose of 90 mg/mo without adverse effects.No distant lymph node or other organ metastases were detected at follow-up.He is in good physical condition and attends regular follow-up visits.CONCLUSION neuroendocrine tumors are rare in clinical practice,and the diagnosis mainly relies on the characteristics of microscopic tumor cells and immunohistochemical features.Treatment involves radical orchiectomy.If it is accompanied by distant lymph node metastasis and the metastatic lesion can be resected,it should be surgically removed;if it cannot be resected,growth inhibitor analog octreotide or

关键词： Testis neuroendocrine tumor Immunohistochemistry Differential diagnosis Somatostatin analog Lanreotide Liver metastasis Treatment Case report

neuroendocrine tumor of Small Intestine, a Diagnostic Challenge

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Open Journal of Gastroenterology 2023年第4期13卷 140-148页

作者： Antonia Rosero Liliana Cuevas Isabella Odarba Elio Fabio Sánchez Samuel Rey Department of Surgery and Specialties Pontificia Universidad Javeriana Bogotá Colombia Division of Surgical Oncology Hospital Universitario San Ignacio Bogotá Colombia

Incidence of neuroendocrine tumors (NET) has significantly increased in the past three decades. In the small intestine, NET are the most frequent tumors, even more frequent than adenocarcinomas. Due to atypical presentations and late symptoms, NET in the small intestine frequently represent a diagnostic challenge. It is important to take these tumors into consideration in differential diagnosis of gastrointestinal neoplasms. Surgeons, oncologists, endocrinologists, and gastroenterologists should understand the disease characteristics and management alternatives. This document aims to review the key points of NET and main diagnostic tools. We present the case of a 50-year-old male who presented lower gastrointestinal bleeding. Imaging and endoscopic studies showed no conclusive findings. A capsule endoscopy showed multiple ulcered lesions with neoplastic aspect in the distal jejune. Due to the multifocal nature of the lesions, clinicians suspected NET-associated digestive bleeding. The patient underwent exploratory laparoscopy with ileectomy and radical abdominal lymphadenectomy. Histopathologic examination confirmed the suspected diagnosis of NET. This case reflects the complexity of diagnostic approach and differential diagnoses for these tumors.

关键词： neuroendocrine tumor Carcinoid tumor Intestinal Cancer Diagnostic Laparoscopy Case Report

Pancreatic neuroendocrine tumors:Are tumors smaller than 2 cm truly indolent?

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1756-1762页

作者： Sergio Hoyos Pablo Posada-Moreno Natalia Guzman-Arango Romario Chanci-Drago Jaime Chavez Alvaro Andrés-Duarte Santiago Salazar-Ochoa Hepatobilary and Liver Transplant Unit Hospital Pablo Tobon Uribe and Gastrohepathology Group Universidad de AntioquiaMedellin 050034AntioquiaColombia Department of General Surgery Universidad Pontificia BolivarianaMedellín 050034AntioquiaColombia

BACKGROUND Pancreatic neuroendocrine tumors(PNETs)are relatively rare but rank as the second most common pancreatic neoplasm.They can be functional,causing early metabolic disturbances due to hormone secretion,or non-functional and diagnosed later based on tumor size-related symptoms.Recent diagnoses of PNETs under 2 cm in size have sparked debates about their management;some practitioners advocate for surgical removal and others suggest observation due to the tumors’lower potential for malignancy.However,it is unclear whether managing these small tumors expectantly is truly safe.AIM To evaluate poor prognostic factors in PNETs based on tumor size(>2 cm ortumors smaller than 2 cm in diameter and those larger than 2 cm in diameter.The recurrence rates between the two tumor groups were furthermore similar:18.2%for tumors smaller than 2 cm and 21.4%for tumors larger than 2 cm.Patient survival was additionally comparable between the two tumor groups.CONCLUSION tumor size does not dictate prognosis;lymph node and lymphovascular involvement affect mortality,which high-lights that histopath

关键词： neuroendocrine tumor Pancreatic neoplasm Pancreas Pancreatic neuroendocrine neoplasm Pancreatic neuroendocrine tumors

Clinical experience sharing on gastric microneuroendocrine tumors: A case report

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World Journal of Clinical Cases 2024年第4期12卷 795-800页

作者： You-Jun Wang Da-Ming Fan Yu-Shuang Xu Qi Zhao Zhen-Fang Li Department of Gastroenterology Central Hospital Affiliated to Shandong First Medical UniversityJinan 250000Shandong ProvinceChina Department of Pathology Central Hospital Affiliated to Shandong First Medical UniversityJinan 250000Shandong ProvinceChina Department of Gastroenterology The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina

BACKGROUND The majority of gastric neuroendocrine tumors(G-NENs)are present in various lesions under endoscopy,and they can be polypoid uplifts,submucosal tumors or papules,erosions,and ulcers.The lesions are mostly confined to the mucosal or submucosal layer,usually less than 2 cm,and exclusively localized to the gastric body or fundus.In type 1 G-NENs,about 22%of cases have no visible lesions under an endoscope,and such lesions can only be detected via biopsies(microcar-cinoids).CONCLUSION In the case under study,the patient did not have any visible raised lesions under a gastroscope,and the lesions were found only after a random biopsy.This article combines the endoscopic manifestations and clinical features of the lesions in this case to improve the diagnosis of G-NENs.

关键词： neuroendocrine tumor Micro carcinoids Endoscopy Case report

Liver collision tumor of primary hepatocellular carcinoma and neuroendocrine carcinoma:A rare case report

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World Journal of Clinical Cases 2022年第35期10卷 13129-13137页

作者： Kuo-Shyang Jeng Chun-Chieh Huang Chen-Shuan Chung Chiung-Fang Chang Department of General Surgery Far Eastern Memorial HospitalNew Taipei 220Taiwan Department of Radiology Far Eastern Memorial HospitalNew Taipei 220Taiwan Department of Internal Medicine Far Eastern Memorial HospitalNew Taipei 220Taiwan Department of Medical Research Far Eastern Memorial HospitalNew Taipei 220Taiwan

BACKGROUND Hepatocellular carcinoma(HCC)can occasionally develop with other non-HCC cell types,either in a combined type or collision type.A collision tumor is defined as two histopathologically distinct tumors of the same organ lacking a clear transition zone.Hepatic collision tumors are rare.Among them,“hepatocellular carcinoma-hepatic neuroendocrine carcinoma”(HCC-NEC)collision tumors are especially rare and information about them is rarely published.CASE SUMMARY A 48-year-old man with typical findings of HCC underwent consecutive therapies,including radiofrequency ablation and embolization prior to resection.Diagnosis of the HCC-NEC collision tumor in the right liver and another HCC in the left liver was established following surgical resection.The patient displayed NEC metastasis following resection and succumbed to septicemia after 2 more rounds of chemotherapy.To our knowledge,this is the 25th reported case of mixed HCC-NEC tumor.The rarity of HCC-NEC collision tumors and the absence of diagnostic criteria make it difficult to differentiate this condition from simple liver tumors,especially in patients with chronic liver disease.CONCLUSION Our case highlights the difficulty in accurately diagnosing HCC-NEC in the absence of histological evidence.The prognosis is poor for this condition,although ultrasound-guided liver biopsy can be helpful to establish a prompt diagnosis.Further accumulation of such cases could help establish an accurate diagnosis earlier.Early discovery of NEC may allow for better treatment strategies and better prognoses.

关键词： Collision tumor Combined tumor Hepatocellular carcinoma neuroendocrine tumor Case report

Role of ablation therapy in conjunction with surgical resection for neuroendocrine tumors involving the liver

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 768-776页

作者： Alexander Ostapenko Stephanie Stroever Lud Eyasu Minha Kim Krist Aploks Xiang Da Dong Ramanathan Seshadri Department of General Surgery Danbury HospitalDanburyCT 06810United States Department of Research and Innovation Nuvance HealthDanburyCT 06810United States Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery Danbury HospitalDanburyCT 06810United States

BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year survival.Ablation can be utilized with surgery to achieve complete resection.Although several studies report long-term out-comes for patients undergoing ablation,none have explored perioperative effects of ablation in patients with metastatic NETs.AIM To determine if intra-operative ablation during hepatectomy increases risk of ad-verse outcomes such as surgical site infections(SSIs),bleeding,and bile leak.METHODS A retrospective analysis of the hepatectomy National Surgical Quality Impro-vement Program database from 2015-2019 was performed to determine the odds of SSIs,bile leaks,or bleeding in patients undergoing intraoperative ablation when compared to hepatectomy alone.RESULTS Of the 966 patients included in the study,298(30.9%)underwent ablation during hepatectomy.There were 78(11.7%)patients with SSIs in the hepatectomy alone group and 39(13.1%)patients with a SSIs in the hepatectomy with ablation group.Bile leak occurred in 41(6.2%)and 14(4.8%)patients in the two groups,respec-tively;bleeding occurred in 117(17.5%)and 33(11.1%),respectively.After con-trolling for confounding variables,ablation did not increase risk of SSI(P=0.63),bile leak(P=0.34)or bleeding(P=0.07)when compared to patients undergoing resection alone on multivariate analysis.CONCLUSION Intraoperative ablation with hepatic resection for NETs is safe in the perioperative period without significant increased risk of infection,bleeding,or bile leak.Surgeons should utilize this modality when appropriate to a-chieve optimal disease control and outcomes.

关键词： Hepatectomy neuroendocrine tumor Ablation Bile leaks Bleeding Surgical site infections

Gastric mixed adenoma-neuroendocrine tumor:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5744-5750页

作者： Shuzo Kohno Hiroaki Aoki Masayuki Kato Masaich Ogawa Kazuhiko Yoshida Department of Surgery The Jikei University Katsushika Medical CenterTokyo 125-8506Katsushika-kuJapan Department of Endoscopy The Jikei University Katsushika Medical CenterTokyo 125-8506Katsushika-kuJapan

BACKGROUND Gastric mixed adenoma-neuroendocrine tumors(NETs)are quite rare.In the 2019 world health organization classification of tumors of the digestive system,these were designated as a combination of grade 1 or grade 2 NETs and adenomas or tubular adenomas.There are no treatment guidelines for these tumors,and pathological and clinical studies are ongoing.Herein,we review previous case reports and present a case of gastric mixed adenoma-NET.CASE SUMMARY A 66-year-old man underwent gastrointestinal endoscopy for the evaluation of upper abdominal pain.Histopathological examination of the biopsy specimen indicated the possibility of gastric cancer.A histopathological examination by endoscopic submucosal dissection showed a mixed adenoma-NET that was completely excised by endoscopic submucosal dissection.No recurrence was observed on gastrointestinal endoscopy at the 6-mo follow-up.CONCLUSION Clinicians'awareness of this rare tumor is important for its timely diagnosis and treatment.

关键词： Adenoma neuroendocrine tumor Diagnosis Pathology Stomach treatment Case report

Calcitonin-negative neuroendocrine tumor of the thyroid with metastasis to liver-rare presentation of an unusual tumor: A case report and review of literature

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World Journal of Clinical Cases 2020年第1期8卷 179-187页

作者： Huai-Jie Cai Han Wang Nan Cao Bin Huang Fan-Lei Kong Li-Ren Lu Ya-Yuan Huang Wei Wang The Fourth Clinical Medicine College Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Ultrasound Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310006Zhejiang ProvinceChina

BACKGROUND neuroendocrine tumors mainly occur in the stomach,intestine,pancreas,and lung and are rarely detected in the thyroid.Thyroid neuroendocrine tumors,designated medullary thyroid carcinoma,generally present with elevated calcitonin.Calcitonin-negative neuroendocrine tumors of the thyroid are extremely rare.CASE SUMMARY Here,we present a case report of a 56-year-old female patient with a neck pain complaint.Total thyroidectomy was conducted after comprehensive evaluation,and diagnosis was confirmed as calcitonin-negative neuroendocrine tumor of the thyroid.Two months later,liver metastasis was detected,and transcatheter arterial chemoembolization was subsequently performed to control growth.However,the curative effect was unsatisfactory and multiple intrahepatic metastases occurred after 3 mo.CONCLUSION Owing to the rarity of this disease,no clear guidelines are available for treatment.In addition to reporting this rare case,we have reviewed and summarized associated medical literature with an aim to provide a comprehensive reference platform for subsequent research.

关键词： Thyroid neuroendocrine tumor Hepatic metastases Diagnosis Treatment Case report

Pancreatic neuroendocrine tumor in a child of 3.5 years old

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World Journal of Pediatrics 2015年第4期11卷 386-388页

作者： Shirin Sayyahfar Seyed Javad Nassiri Mitra Mehrazma Mahnaz Sadeghian Department of Pediatrics Iran University of Medical SciencesAli Asghar Children HospitalVahid Dastgerdi StreetShariati StreetTehranIran Pediatric Surgery Iran University of Medical SciencesAli Asghar Children HospitalVahid Dastgerdi StreetShariati StreetTehranIran Pathology Iran University of Medical SciencesAli Asghar Children HospitalVahid Dastgerdi StreetShariati StreetTehranIran

Background:Pancreatic neuroendocrine tumor is rarely seen,particularly in children.One of the symptoms of this tumor is jaundice that may be misdiagnosed as the sign of hepatitis A,especially in countries with a high prevalence of this infectious disease.Methods:We present a 3.5-year-old girl with four weeks of icterus,who was misdiagnosed with hepatitis A.Results:The patient wasfi nally diagnosed as having a low grade pancreatic neuroendocrine carcinoma.Conclusion:Pediatricians should be aware of or consider a tumor in differential diagnosis of jaundice,especially prolonged one in children.

关键词： hepatitis A icterus neuroendocrine tumor pancreatic tumor