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Shao Y, Gui Y, Cheng Y, Xu J, Chang X, Lv K. Case report: Peritumoral hepatic steatosis in a patient with a metastatic somatostatin-producing oligosymptomatic neuroendocrine neoplasm. Front Oncol 2022; 12:1013017. [DOI: 10.3389/fonc.2022.1013017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Neuroendocrine neoplasms (NENs) comprise a heterogeneous collection of tumors derived from various neuroendocrine cells and are divided into functioning NEN and non-functioning NEN. Some NENs present with mild symptoms and can secrete somatostatin. These neoplasms are known as somatostatin-producing oligosymptomatic NENs. In this report, we describe a case of metastatic somatostatin-producing oligosymptomatic NEN with peritumoral hepatic steatosis and review the relevant literature. The patient was a 45-year-old woman who presented with mild steatorrhea and melena. A computed tomography scan revealed an enlarged pancreas protruding into the duodenum. Pathology after total pancreatectomy showed a grade 2 pancreatic NEN with positive somatostatin immunostaining. Enlarging masses on the liver were observed after the operation. Ultrasound examination revealed several lesions in the liver, with inner hypoechoic areas that showed rapid enhancement and fast washout on contrast-enhanced ultrasonography and with outer hyperechoic areas with continuous iso-enhancement. Therefore, the inner hypoechoic areas seen on contrast-enhanced ultrasonography were suspected to be true metastases. A biopsy confirmed this suspicion and indicated that the outer areas were peritumoral liver steatosis. This case highlights the importance of the imaging pattern described in this report for accurate diagnosis of metastatic NEN to avoid incorrect estimation of tumor size or a missed diagnosis on biopsy.
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Vyas M, Zhang X, Morrow JS, Jain D, Salem RR, West AB. Focal hepatic glycogenosis associated with metastatic insulinoma presenting as mass lesions. Pathol Res Pract 2016; 212:59-62. [PMID: 26627264 DOI: 10.1016/j.prp.2015.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/25/2015] [Accepted: 11/09/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Monika Vyas
- Department of Pathology, Yale University Medical School and Yale New Haven Hospital, New Haven, CT, United States.
| | - Xuchen Zhang
- Department of Pathology, Yale University Medical School and Yale New Haven Hospital, New Haven, CT, United States
| | - Jon S Morrow
- Department of Pathology, Yale University Medical School and Yale New Haven Hospital, New Haven, CT, United States
| | - Dhanpat Jain
- Department of Pathology, Yale University Medical School and Yale New Haven Hospital, New Haven, CT, United States
| | - Ronald R Salem
- Department of Surgery, Yale University Medical School and Yale New Haven Hospital, New Haven, CT, United States
| | - A Brian West
- Department of Pathology, Yale University Medical School and Yale New Haven Hospital, New Haven, CT, United States
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Borghei P, Pan Z, Berland LL. Peritumoural steatosis in metastatic “non-functioning” neuroendocrine tumour of the pancreas. Clin Radiol 2012; 67:1027-9. [DOI: 10.1016/j.crad.2012.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 02/19/2012] [Accepted: 02/26/2012] [Indexed: 11/28/2022]
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Martin-Benitez G, Marti-Bonmati L, Barber C, Vila R. Hepatic lipomas and steatosis: An association beyond chance. Eur J Radiol 2012; 81:e491-4. [DOI: 10.1016/j.ejrad.2011.06.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Revised: 05/29/2011] [Accepted: 06/01/2011] [Indexed: 12/29/2022]
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Abstract
This article reviews the rationale and data behind recommending lifestyle changes to prevent and reverse NASH, focusing specifically on changes that lead to increased physical activity in sedentary patients, changes in dietary habits, and decreased calorie consumption to achieve gradual and sustained weight loss in those who are overweight or obese. In a culture that values avoiding even minimal exertion these are not easy changes to make. Ultimately, the success of care providers in helping patients to recognize and overcome these barriers depends on a patient's motivation, but clinicians can be more persuasive and able to bolster this motivation when armed with a conviction based on data that establish this to be the best course of action for patients with NASH.
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Affiliation(s)
- Brent A Neuschwander-Tetri
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, 3635 Vista Avenue, St. Louis, MO 63110, USA.
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Pezzilli R, Ricci C, Serra C, Casadei R, Monari F, D’Ambra M, Corinaldesi R, Minni F. Current medical treatment of pancreatic neuroendocrine tumors. Cancers (Basel) 2007; 2:1419-31. [PMID: 24281165 PMCID: PMC3837314 DOI: 10.3390/cancers2031419] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 06/28/2010] [Accepted: 06/30/2010] [Indexed: 02/07/2023] Open
Abstract
Pancreatic neuroendocrine tumors (NETs) consist of a wide group of neoplasms, with different biological behaviors in terms of aggressiveness and hormone production. In the last two decades, significant progress has been observed in our understanding of their biology, diagnosis and treatment. Surgery remains to be the only curative approach, but unfortunately the diagnosis is often delayed due to the slow growth of these tumors and the difficulty in identifying the symptoms related to the tumor-released hormones. In addition to surgery, other approaches to control the disease are biological therapy consisting of somatostatin analogs and interferon (IFN), systemic chemotherapy, radioligand therapy and local therapy with chemoembolization. Several newer cytotoxic agents, including irinotecan, gemcitabine, taxanes, oxaliplatin, capecitabine and PS-341 have been studied in metastatic patients. Considering the high vascularity of these tumors, antiangiogenic agents like endostatin and thalidomide have also been evaluated in advanced NETs. Although these agents seem to have potential activity in NETs and may increase progression free survival, none of these currently available medical therapeutic options are curative. While more efficient novel strategies are to be developed, the rationale use of the current therapeutic options may improve quality of life, control the symptoms related to the hypersecretion of hormones and/or peptides, control tumor proliferation and prolong survival in patients suffering from NETs.
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Affiliation(s)
- Raffaele Pezzilli
- Department of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; E-Mail: (C.S.); (R.C.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +39-051-636-4148
| | - Claudio Ricci
- Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; E-Mails: (C.R.); (R.C.); (F.M.); (M.D’A.); (F.M.)
| | - Carla Serra
- Department of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; E-Mail: (C.S.); (R.C.)
| | - Riccardo Casadei
- Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; E-Mails: (C.R.); (R.C.); (F.M.); (M.D’A.); (F.M.)
| | - Francesco Monari
- Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; E-Mails: (C.R.); (R.C.); (F.M.); (M.D’A.); (F.M.)
| | - Marielda D’Ambra
- Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; E-Mails: (C.R.); (R.C.); (F.M.); (M.D’A.); (F.M.)
| | - Roberto Corinaldesi
- Department of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; E-Mail: (C.S.); (R.C.)
| | - Francesco Minni
- Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; E-Mails: (C.R.); (R.C.); (F.M.); (M.D’A.); (F.M.)
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