1
|
DelBaugh RM, Kerr DA, Dominguez-Konicki L, Beard JA, Gordon SR, Adler JM, Liu X. Metastatic Neuroendocrine Neoplasms to the Pancreas: Two Unusual Cases and a Review of the Literature. Int J Surg Pathol 2024; 32:523-532. [PMID: 37461216 DOI: 10.1177/10668969231185067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Neuroendocrine tumor metastases to the pancreas are rare, and they share substantial overlap with the significantly more common primary pancreatic neuroendocrine neoplasms, representing a potential diagnostic pitfall. Elucidating whether a neuroendocrine tumor within the pancreas is a primary neoplasm versus a metastasis has significant prognostic and treatment implications. Correlation with clinical history and imaging as well as incorporating an appropriate immunohistochemical panel are essential to establish the correct diagnosis. Herein, we present 2 rare neuroendocrine tumors that metastasized to the pancreas: a medullary thyroid carcinoma and an atypical carcinoid tumor of lung origin. We also provide a brief review of the literature.
Collapse
Affiliation(s)
- Regina M DelBaugh
- Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Darcy A Kerr
- Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Jonathan A Beard
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Department of Gastroenterology and Hepatology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Stuart R Gordon
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Department of Gastroenterology and Hepatology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Jeffrey M Adler
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Department of Gastroenterology and Hepatology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Xiaoying Liu
- Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| |
Collapse
|
2
|
Soldath P, Bianchi D, Manfredini B, Kjaer A, Langer SW, Knigge U, Melfi F, Filosso PL, Petersen RH. Prognostic Thresholds of Mitotic Count and Ki-67 Labeling Index for Recurrence and Survival in Lung Atypical Carcinoids. Cancers (Basel) 2024; 16:502. [PMID: 38339254 PMCID: PMC10854613 DOI: 10.3390/cancers16030502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/04/2024] [Accepted: 01/14/2024] [Indexed: 02/12/2024] Open
Abstract
Atypical carcinoid (AC) is a rare neuroendocrine neoplasm of the lung, which exhibits a varying malignant potential. In this study, we aimed to identify the prognostic thresholds of the mitotic count and Ki-67 labeling index for recurrence and survival in AC. We retrospectively reviewed 78 patients who had been radically resected for AC and calculated said thresholds using time-dependent receiver operating characteristic curves and the Youden index. We then dichotomized the patients into groups of above or below these thresholds and estimated the cumulative incidences of the groups using the Aalen-Johansen estimator. We compared the groups using univariable and multivariable Fine-Gray subdistribution hazard models. Our findings show that more patients recurred and died from this disease if their mitotic count exceeded three and four mitoses per 2 mm2, respectively, or if their Ki-67 labeling index exceeded 14% and 11%, respectively. Both thresholds independently predicted survival (p < 0.001 and p = 0.015, respectively). These thresholds may serve as a valuable tool for clinicians and researchers in making treatment plans and predicting outcomes for patients with AC.
Collapse
Affiliation(s)
- Patrick Soldath
- European Neuroendocrine Tumor Society Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (A.K.); (S.W.L.); (U.K.); (R.H.P.)
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Cardiothoracic Surgery, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| | - Daniel Bianchi
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy; (D.B.); (P.L.F.)
| | - Beatrice Manfredini
- Minimally Invasive and Robotic Thoracic Surgery, Surgical, Medical, Molecular, and Critical Care Pathology Department, University of Pisa, 56126 Pisa, Italy; (B.M.); (F.M.)
| | - Andreas Kjaer
- European Neuroendocrine Tumor Society Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (A.K.); (S.W.L.); (U.K.); (R.H.P.)
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Clinical Physiology and Nuclear Medicine & Cluster for Molecular Imaging, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Seppo W. Langer
- European Neuroendocrine Tumor Society Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (A.K.); (S.W.L.); (U.K.); (R.H.P.)
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Oncology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| | - Ulrich Knigge
- European Neuroendocrine Tumor Society Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (A.K.); (S.W.L.); (U.K.); (R.H.P.)
- Department of Surgical Gastroenterology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Endocrinology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| | - Franca Melfi
- Minimally Invasive and Robotic Thoracic Surgery, Surgical, Medical, Molecular, and Critical Care Pathology Department, University of Pisa, 56126 Pisa, Italy; (B.M.); (F.M.)
| | - Pier Luigi Filosso
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy; (D.B.); (P.L.F.)
| | - René Horsleben Petersen
- European Neuroendocrine Tumor Society Center of Excellence, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (A.K.); (S.W.L.); (U.K.); (R.H.P.)
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Cardiothoracic Surgery, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| |
Collapse
|