1/34. Neuroendocrine carcinoma of the uterus.Neuroendocrine carcinomas of the cervix and endometrium were reviewed. They have been variously designated as carcinoid, argyrophil cell carcinoma, apudoma, small cell carcinoma, oat cell carcinoma, endocrine carcinoma, and neuroendocrine carcinoma, the last-mentioned term being preferred in this chapter. Adenocarcinomas with neuroendocrine cells are occasionally encountered in the cervix and endometrium. It is generally questioned whether they should be included in the spectrum of neuroendocrine carcinomas, although differential diagnosis between some such tumors of the gastrointestinal tract and neuroendocrine carcinoma is reported to be difficult. Since the majority of neuroendocrine carcinomas of the cervix are highly aggressive, it is important to establish the neuroendocrine nature in the cervical carcinomas. In addition to the characteristic histologic features and argyrophil stainability, immunohistochemical demonstration of several neuroendocrine markers may be helpful in diagnosing neuroendocrine carcinoma of the cervix. Ultrastructural demonstration of neurosecretory granules is almost decisive in establishing the tumor's neuroendocrine nature, but it is not applicable in all cases. Neuroendocrine carcinomas of the cervix have been treated by surgery, radiation therapy, and chemotherapy, but optimal treatment methods have not yet been established because of the rarity of the tumor. Finally, we have described a typical neuroendocrine carcinoma of the cervix and reported some data regarding its experimental study.- - - - - - - - - - ranking = 1keywords = endocrine (Clic here for more details about this article) |
2/34. A metastatic endocrine-neurogenic tumor of the ampulla of vater with multiple endocrine immunoreaction--malignant paraganglioma?The present case report demonstrates the history of a 50-year-old man with a mixed endocrine-neurogenous tumor of the ampulla of vater. The tumor was localized endoscopically after an attack of melena. There were no signs of endocrinopathy. A local resection with suturing of the pancreatic duct was performed. Morphologically, there were two different tissue types (neurogenous and carcinoid-like) with numerous cells and nerve fibers reacting immunohistochemically with somatostatin and neurotensin antisera: some immunoreactivity to PP-antibodies was observed. Still, after 20 months, the patient seems to have been cured by local resection.- - - - - - - - - - ranking = 1.9844775600824keywords = multiple endocrine, endocrine (Clic here for more details about this article) |
3/34. The progressive zollinger-ellison syndrome in multiple endocrine neoplasia.The problem of hypergastrinemia in patients with the syndrome of multiple endocrine neoplasia (men type 1) has become increasingly controversial since the introduction of the antisecretory H2 antagonists for the treatment of the zollinger-ellison syndrome (ZES). One of the questions in the management of ZES is whether the malignant potential of the gastrinomas or the recurrent complications of ulcer will be the ultimate cause of death. Another problem is whether the association of men is a favorable or unfavorable factor to the prognosis of patients with ZES. hypercalcemia contributes to excessive gastrin secretion, thereby casting doubt on the diagnosis of ZES in the presence of men. patients with men are also more likely than patients with ZES not to have gastrinoma on an exploratory laparotomy. The existing controversy concerns the choices of therapy in instances of progressive ZES associated with men or when there is a failure to detect a primary gastrinoma when exploration is performed. To highlight the debate, the clinical courses of two patients, observed during two and three decades, respectively, are presented. These patients were receiving high doses of cimetidine; in addition, conventional surgical treatment for ulcer and repeated biopsies for gastrinoma were performed. After total gastrectomies (as life saving procedures), both patients are well.- - - - - - - - - - ranking = 2.8238248441973keywords = multiple endocrine, endocrine neoplasia, endocrine, multiple endocrine neoplasia, neoplasia (Clic here for more details about this article) |
4/34. Cytomorphology and marker expression of malignant neuroendocrine cells in pleural effusions.Three cases of pulmonary neuroendocrine carcinoma with malignant pleural effusions were retrospectively studied to determine if cellular morphology and expression of neuroendocrine markers were the same in the fluid as in the solid milieu. In fluids, changes were noted in cell grouping, shape and cytoplasm. Neuroendocrine markers expressed in both solid and dispersed tumors were neuron-specific enolase (NSE) in all cases and leu-enkephalin in one case. Vasoactive intestinal polypeptide (two cases) and serotonin (one case) were detected only in the solid tumor. ACTH, bombesin and calcitonin were not expressed. We tentatively conclude that, in effusions, neoplastic neuroendocrine cells may alter their cytostructure, growth patterns and marker expression capabilities. NSE appears to be the most reliable neuroendocrine marker for use in small samples and with varying preparatory methods.- - - - - - - - - - ranking = 0.52941176470588keywords = endocrine (Clic here for more details about this article) |
5/34. iodine-131 MIBG scintigraphy of neuroendocrine tumors other than pheochromocytoma and neuroblastoma.Metaiodobenzylguanidine (MIBG) locates most pheochromocytomas and neuroblastomas. The tracer is concentrated in intracellular storage vesicles by an active process. Many other neuroendocrine tumors of the amine precursor uptake and decarboxylation (APUD) series have hormonal storage vesicles and, thus, the potential to take up [131I]MIBG. A variety of neuroendocrine tumors in 57 patients were studied 1, 2, and 3 days after 0.5 mCi [131I]MIBG. Views from skull to pelvis were obtained. Results of MIBG scans were compared with all available imaging modalities (including plain radiography, liver scan, ultrasound, computed tomography, and angiography) and surgical exploration. The neuroendocrine nature of the tumor was determined by histology, immunohistochemistry, electron microscopy, and the assay of appropriate biogenic amines and peptide hormones. Results were (positive/total cases): carcinoids (four of ten), nonsecreting paragangliomas (three of three), sporadic medullary carcinomas of the thyroid (MCT) (one of five), familial MCT (one of 26), chemodectomas (two of five), oat cell carcinomas (zero of four), choriocarcinoma (one of one), atypical schwannoma (with storage granules) (one of one), Merkel cell skin cancer (one of one), islet cell carcinoma (zero of one). We conclude that a wide range of neuroendocrine tumors show [131I]MIBG uptake; tumors other than pheochromocytomas and neuroblastomas are less often seen scintigraphically, but in certain cases (e.g., carcinoid and nonsecreting paragangliomas) scintigraphy may be useful in depicting the extent and location of disease and may indicate therapeutic potential. iodine-131 MIBG shows promise in the diagnosis and staging of tumors of varied types.- - - - - - - - - - ranking = 0.47058823529412keywords = endocrine (Clic here for more details about this article) |
6/34. Neuroendocrine (Merkel cell) carcinoma of the skin. Its natural history, diagnosis, and treatment.Over 400 cases of neuroendocrine (Merkel cell) carcinoma of the skin (NCS) have been reported. This tumor continues to pose problems in diagnosis and effective treatment for physicians unfamiliar with its biological characteristics. Reported here are five additional cases of NCS and the literature for this rare neoplasm is comprehensively reviewed. An early and accurate diagnosis is made possible by combining clinical presentation with results of histologic study, immunoperoxidase staining for neuron-specific enolase (NSE), epithelial membrane antigen (EMA), cytokeratins, and electron microscopy. NCS is an aggressive tumor. Depending on the length of follow-up, up to 40% of tumors locally recur, 55% develop regional nodal metastases, and 36% undergo distant metastasis. Survival is sex, but not age, dependent, with an overall 2-year survival rate of 72% (males 58% vs. females 79%). No standard procedure for initial and/or follow-up treatment for NCS exists. The authors recommend that NCS be treated, whenever possible, using the same rationale as applied for the treatment of squamous cell carcinoma of the skin.- - - - - - - - - - ranking = 0.29433785529109keywords = endocrine, neoplasm (Clic here for more details about this article) |
7/34. iodine-123 MIBG imaging in a generalized pancreatic polypeptide-gastrin-serotonin secreting tumor.The usefulness of radio-metaiodobenzylguanidine (MIBG), a specific radiopharmaceutical agent for scintigraphic imaging and treatment of phaeochromocytoma and neuroblastoma, has been extended to the location of carcinoid tumors. Scintigraphic evaluation with I-123 MIBG in a patient with a histologically proven endocrine tumor (apudoma) of unknown origin with liver and bone metastases is reported. Elevated plasma hormone levels of gastrin, pancreatic polypeptide, and serotonin were found. Tumoral content of these hormones was immunocytochemically confirmed on liver biopsy. I-123 MIBG uptake could be seen in those areas of the liver with deficient lesions in the Tc-99m colloid image with a maximal uptake in a large mass at the level of the left liver lobe. No abnormal uptake could be observed at any other level, which was in contrast with autopsy findings of generalized metastatic disease.- - - - - - - - - - ranking = 0.058823529411765keywords = endocrine (Clic here for more details about this article) |
8/34. Merkel cell carcinoma.Merkel cell carcinoma is a rare malignant neoplasm of the skin which is locally invasive and frequently metastasizes to lymph nodes, liver, lungs, bone, and brain. Computed tomographic and pathologic findings in an elderly woman with Merkel cell carcinoma of the buttock and regional nodal metastasis are reported. The presence of calcitonin and neuron-specific enolase within the tumor supports the theory that Merkel cell carcinoma is a neuroendocrine tumor derived from the APUD (amine precursor uptake and decarboxylase) system.- - - - - - - - - - ranking = 0.059043737644034keywords = endocrine, neoplasm (Clic here for more details about this article) |
9/34. Immunocytochemical localization of calcitonin-producing cells in a strumal carcinoid with amyloid stroma.A nonfunctioning strumal carcinoid arising in a 49-year-old woman was studied by histochemical and immunocytochemical techniques. All tumor cells, irrespective of their architectural arrangement, showed properties of neuroendocrine-programmed cells, without any evidence of thyroid follicular cell differentiation. Foci of calcitonin-producing C-cells were demonstrable by immunocytochemical technique and were closely associated with areas of amyloid stroma of the tumor. Efforts at localization of insulin and gastrin within the tumor cells gave negative results. While the results in the present case offer additional support for an APUD cell origin of strumal carcinoids, the presence of the calcitonin-producing C-cells within the tumor raises interesting histogenetic possibilities as to whether these lesions are derived from C-cells or represent an ovarian carcinoid with foci of C-cell differentiation.- - - - - - - - - - ranking = 0.058823529411765keywords = endocrine (Clic here for more details about this article) |
10/34. Carcinoid of the uterine cervix: a case report with light and electron microscopic studies.The case of a 33-year-old woman with primary carcinoid of the uterine cervix is reported. Primary carcinoid tumor is well known to occur in organs such as the gastrointestinal tract, lung and gonads. However, its occurrence in the uterine cervix is rare. To our knowledge, primary carcinoid of the uterine cervix has not been reported from the united states, although it has been well documented by non-American authors. light microscopically, the tumor was characterized by formation of solid nests, trabeculae and glands. The cells therein showed argyrophil granules but were negative for argentaffin reaction. Electron microscopy revealed the presence of numerous neurosecretory granules and microfilaments. On the basis of light microscopic ultrastructural and cytochemical properties, the tumor is believed to arise from the normal argyrophil cell of the cervix and is regarded as an endocrine tumor, a member of the group of neoplasms called apudomas.- - - - - - - - - - ranking = 0.059043737644034keywords = endocrine, neoplasm (Clic here for more details about this article) |
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