No abstract available.
Diagnosis ; Neuroendocrine Tumors

Neuroendocrine tumors of the female reproductive tract are a heterogeneous group of neoplasms that display various histologic findings and biologic behaviors. In this review, the classification and clinicopathologic characteristics of neuroendocrine tumors of the female reproductive tract are described. Differential diagnoses are discussed, especially for non-neuroendocrine tumors showing high-grade nuclei with neuroendocrine differentiation. This review also discusses recent advances in our pathogenetic understanding of these disorders.
Carcinoma, Neuroendocrine ; Classification ; Diagnosis, Differential ; Female* ; Humans ; Neuroendocrine Tumors*

Multidisciplinary team(MDT) has been considered as the best practice in the treatment planning and care for patients with cancer around the world. With the increased range and number of specialists involved, multidisciplinary coordination and communication have been enhanced, and the efficiency and quality of diagnosis and treatment of cancer have been improved. Neuroendocrine neoplasm (NEN) is a heterogeneous group of tumors originating from neuroendocrine cells located throughout the body, most of which is gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN). Due to the low incidence of GEP-NEN, the knowledge of such rare disease went through a long way of exploration, and a large number of unresolved issues still plagued the clinicians. An effective diagnosis of GEP-NEN requires a multimodal approach that combines evaluation of clinical symptoms and hormone levels, radiological and nuclear imaging, and histological confirmation. The treatment is complex, including surgery, oncology, radiotherapy,peptide receptor radionuclide treatment (PRRT) and interventional therapy, so MDT model should play an important role in the diagnosis and treatment of GEP-NEN to maximize the integration of multidisciplinary resources and improve the life quality as well as survival. A NEN-MDT was organized in 2013 by the Beijing Cancer Hospital, including oncology, surgery, pathology, nuclear medicine and radiology. This paper investigates the significance and management in the implementation of MDT model in the diagnosis and treatment of GEP-NEN, based on the experience of MDT operation in our center.
Diagnosis, Differential ; Humans ; Neuroendocrine Tumors ; diagnosis ; Patient Care Team

Upper gastrointestinal neuroendocrine tumors (NETs) are rare tumors which are increasingly recognised by practising endoscopists. After confirmation by endoscopic biopsies of these focal lesions, many questions may arise. As NETs are less frequently encountered compared to other malignancies or gastrointestinal pathology, many endoscopists may not fully understand the natural history, diagnosis and management of these tumors. In this review, we aim to update the practising endoscopist on the key clinical features and management of patients with upper gastrointestinal NET.
Biopsy ; Diagnosis* ; Humans ; Natural History ; Neuroendocrine Tumors* ; Pathology

Accurate diagnosis of pancreatic solid lesions is often difficult using conventional imaging modalities. With the recent introduction of contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS), it is now possible to evaluate the microvascular environment and dynamic enhancement of a variety of pancreatic lesions. With CEH-EUS, three patterns of pancreatic lesion enhancement compared with the normal pancreatic tissue (fast, simultaneous, or slow), two washout patterns (fast or slow) and two distribution patterns (homogeneous, inhomogeneous) can be described. By evaluating the microvasculature, enhancement speed, and washout pattern, CEH-EUS may help to differentiate pancreatic adenocarcinoma from other masses and differentiate between pancreatic neuroendocrine tumor (pNET) and inflammatory masses. The finding of a hyperenhancing lesion on CEH–EUS, both with homogeneous and inhomogeneous patterns, was a strong predictor of histology different from adenocarcinoma (94% positive predictive value). pNET was the most common hyperenhancing lesions overall. Although CEH-EUS is useful for ruling out pancreatic ductal adenocarcinoma, making the differential diagnosis between pNETs and pseudotumoral pancreatic masses is difficult because both may share an isovascular or hypervascular appearance. Currently the interpretation of CEH-EUS findings is examiner-dependent. In the future, digital image analysis by image-processing techniques should allow more objective interpretation.
Adenocarcinoma ; Diagnosis ; Diagnosis, Differential ; Microvessels ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors ; Pancreatic Ducts ; Ultrasonography*

Neuroendocrine tumors of the gallbladder are rare, and typically found incidentally after a cholecystectomy. Few data are available on adrenocorticotrophic hormone (ACTH)-producing neuroendocrine tumors originating specifically from the gallbladder. We experienced the case of a patient with a gallbladder mass who presented with Cushing's syndrome, who was subsequently diagnosed as an ACTH-producing neuroendocrine carcinoma of the gallbladder. Despite being rare, hormone-producing neuroendocrine tumors should be part of the differential diagnosis in patients with Cushing's syndrome.
ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone ; Carcinoma, Neuroendocrine* ; Cholecystectomy ; Cushing Syndrome* ; Diagnosis, Differential ; Gallbladder* ; Humans ; Neuroendocrine Tumors

Neuroendocrine neoplasms of the larynx arise from APUD (amine precursor uptake and decarboxylase) cells. Neuroendocrine neoplasms of the larynx canbe divided into those of epithelial or neural origin. The latter consists of paragangliomas while the group of the epithelial origin can be further divided into typical and atypical carcinoids, and small cell neuroendocrine carcinoma, which consist of the oat cell type, the intermediate cell type and the combined cell type. There are now over 500 cases of neuroendocrine neoplasms of the larynx reported in the literature. The diagnosis is primarily based on light microscopy and; in some instances, it may be supported by special histochemical studies. It should be confirmed by immunocytochemical and/or ultrastructural investigation. The different biological behavior of neuroendocrine neoplasms of the larynx makes a specific diagnosis of paramount importance, since treatment depends on accurate diagnosis. We experienced 4 cases of neuroendocrine carcinoma of the larynx, and which we report with a review of literatures.
Avena ; Carcinoid Tumor ; Carcinoma, Neuroendocrine ; Diagnosis ; Laryngeal Neoplasms ; Larynx* ; Microscopy ; Neuroendocrine Tumors* ; Paraganglioma

Endoscopic resection of gastric subepithelial tumors (SETs) has several advantages over biopsy techniques, such as superior diagnostic yield and definite diagnosis. Removal of gastric SETs and histopathologic confirmation should be considered whenever gastric SETs are highly suspected to have malignant potential such as gastrointestinal stromal tumor (GIST) or neuroendocrine tumor. According to our clinical experience, we suggest that endoscopic resection of gastric SETs is feasible for GISTs less than 3.0 cm without positive endoscopic ultrasonography findings or for hypoechoic SETs less than 3.0 cm. However, serious complications such as macroperforation may occur during endoscopic resection, and this procedure is highly dependent on endoscopists' skills. We recently reported the long-term clinical outcomes of endoscopic resection of gastric GIST, which showed a relatively low recurrence rate (2.2%) during long-term follow-up (46.0±28.5 months) despite the low R0 resection rate (25.0%). We suggest that endoscopic surveillance might be possible without additional surgical resection in completely resected GISTs without residual tumor confirmed to be lower risk, even if they show an R1 resection margin.
Biopsy ; Diagnosis ; Endoscopy ; Endosonography ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Neoplasm, Residual ; Neuroendocrine Tumors ; Recurrence

We report the case of a 16-year-old boy with a solid pancreatic mass which proved to be a nonfunctioning, malignant pancreatic neuroendocrine tumor (PNET). In pediatric patients, malignant pancreatic tumors are rare, especially malignant PNET. When dynamic contrast enhanced MRI showed a well enhancing solid pancreatic tumor on arterial and delayed phases and combined with malignant features, such as vascular invasion, invasion of adjascent organs, and lymphadenopathy, we should include malignant pancreatic neuroendocrine tumor in the differential diagnosis of childhood pancreatic tumors.
Adenoma, Islet Cell ; Adolescent ; Child ; Diagnosis, Differential ; Humans ; Lymphatic Diseases ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors

Solitary fibrous tumors (SFTs) are histologically characterized as mesenchymal tumors of probable fibroblastic origin that can arise at pleural and extrapleural sites. SFTs originating in the pancreas are extremely rare. Here, we report a case of pancreatic SFT in a 77-year-old female who presented with jaundice. A malignant neuroendocrine tumor (NET) was suspected based on radiologic findings. However, it is difficult to differentiate SFTs from a NET from radiographs and in this report, we summarize magnetic resonance imaging findings and discuss how to distinguish between SFT and NET using immunohistochemistry. Radical excision is the treatment of choice for SFT; however, in the present case, excision was not possible and close observation showed no changes 10 months after the diagnosis.
Aged ; Diagnosis ; Female ; Fibroblasts ; Humans ; Immunohistochemistry ; Jaundice ; Magnetic Resonance Imaging ; Neuroendocrine Tumors ; Pancreas* ; Solitary Fibrous Tumors*