• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.293-297
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• 2017

Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor that is highly aggressive in nature and indolent in progression. The common risk factors for MCC are senility, prolonged exposure to sunlight, and immune deficient states. Moreover, Merkel cell polyomavirus has recently been characterized to be significantly associated with pathogenesis of MCC, including the expression of Cytokeratin 20 (CK20). Diagnosis is often difficult since histopathological results require a number of differential diagnoses through immunohistochemical (IHC) stains with other cutaneous malignancies. A 67-year-old man presented with a solitary dome-shaped erythematous round mass on the left upper arm for 2 months. Biopsy and IHC studies revealed findings consistent with Merkel Cell Carcinoma of neuroendocrine origin. Common IHC stains usually confirm positive findings for CK20, which is also recognized as the key component in making the diagnosis. We present a CK20 negative MCC in light of expanding the knowledge of unusually stained IHC results in MCC.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2205-2210
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• 2014

Objective: To retrospectively review the clinical characteristics and analyze the prognostic factors of Chinese patients with pulmonary neuroendocrine tumors. Materials and Methods: The clinical data of 176 patients with pulmonary neuroendocrine tumors in Chinese PLA General Hospital from Mar., 2000 to Oct., 2012 were retrospectively analyzed. The parameters were evaluated by univariate and multivariate analysis, including the gender, age, smoking history, family history, TNM staging, localization (central or peripheral), tumor size, nodal status, histological subtype and treatment (operation or non-operation). Results: There were 23 patients with typical carcinoids (TC) (13.1%), 41 with atypical carcinoids (AC) (23.3%), 10 with large cell neuroendocrine carcinoma (LCNEC) (5.7%) and 102 with small cell lung cancer (SCLC) (57.9%). The median follow-up time was 64.5 months for AC, 38 months for LCNEC and 27 months for SCLC. The typical carcinoid censored data was 18 (more than 50% of the patients), so the median follow-up time was not obtained, and actuarial 5-year survivals for TC, AC, LCNEC and SCLC were 75.1%, 51.7%, 26.7% and 38.8%, respectively. COX univariate analysis revealed that the age (P=0.001), histological subtype (P=0.005), nodal status (P=0.000), treatment (P=0.000) and TNM staging (P=0.000) were the prognostic factors of the patients with pulmonary neuroendocrine tumors, whereas its multivariate analysis showed that only the age(P=0.001), TNM staging (P=0.002) and treatment (P=0.000) were independent prognostic factors. Conclusions: Radical surgery remains the treatment of choice, and is the only curative option. The age, TNM staging and treatment are confirmed to be the independent prognostic factors in multivariable models for pulmonary neuroendocrine tumors.

• 한국간담췌외과학회지
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• 제27권1호
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• pp.107-113
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• 2023

Mixed adenoneuroendocrine carcinoma is defined as a tumor with a mixture of adenocarcinoma components and neuroendocrine neoplasm components. Each of these two components of mixed adenoneuroendocrine carcinoma accounts for at least 30% of all tumors. Mixed adenoneuroendocrine carcinoma might be located in the ampulla of Vater, a very rare location compared to other organs. Thus, its treatment and prognosis plans have not been established yet. We report three cases of mixed adenoneuroendocrine carcinoma occurring in the ampulla of Vater. Each patient had a different clinical course. In general, difficulty in preoperative diagnosis, risk of early recurrence, and poor disease course were main hallmarks of mixed adenoneuroendocrine carcinoma arising from the ampulla of Vater. However, one patient in this case report survived although she did not receive adjuvant chemotherapy due to her old age. Therefore, it is important to establish a careful treatment strategy for mixed adenoneuroendocrine carcinoma arising from the ampulla of Vater.

• 대한세포병리학회:학술대회논문집
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• 대한세포병리학회 1991년도 제5차 춘계학술대회 초록집
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• pp.22.2-23
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• 1991

• 대한소화기학회지
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• 제72권6호
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• pp.318-321
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• 2018

Primary neuroendocrine tumors originating from the extrahepatic bile duct are rare. Among these tumors, large cell neuroendocrine carcinomas (NECs) are extremely rare. A 59-year-old man was admitted to Sanggye Paik Hospital with jaundice that started 10 days previously. He had a history of laparoscopic cholecystectomy, which he had undergone 12 years previously due to chronic calculous cholecystitis. Laboratory data showed abnormally elevated levels of total bilirubin 15.3 mg/dL (normal 0.2-1.2 mg/dL), AST 200 IU (normal 0-40 IU), ALT 390 IU (normal 0-40 IU), and gamma-glutamyl transferase 1,288 U/L (normal 0-60 U/L). Serum CEA was normal, but CA 19-9 was elevated 5,863 U/mL (normal 0-37 U/mL). Abdominal CT revealed a 4.5 cm sized mass involving the common bile duct and liver hilum and dilatation of both intrahepatic ducts. Percutaneous transhepatic drainage in the left hepatic duct was performed for preoperative biliary drainage. The patient underwent radical common bile duct and Roux-en-Y hepaticojejunostomy for histopathological diagnosis and surgical excision. On histopathological examination, the tumor exhibited large cell NEC (mitotic index >20/10 high-power field, Ki-67 index >20%, CD56 [+], synaptophysin [+], chromogranin [+]). Adjuvant concurrent chemotherapy and radiotherapy were started because the tumor had invaded the proximal resection margin. No recurrence was detected at 10 months by follow-up CT.

• Journal of Chest Surgery
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• 제55권2호
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• pp.101-107
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• 2022

Background: Spread through air spaces (STAS) has recently emerged as a prognostic factor in lung adenocarcinoma, but little is known about the association of STAS and its grade with recurrence in neuroendocrine tumors (NETs). This study investigated the prognostic effect of STAS grade in NETs after curative resection. Methods: Seventy-seven patients were retrospectively reviewed, including 9 with typical carcinoid (TC), 6 with atypical carcinoid (AC), 26 with large cell neuroendocrine carcinoma (LCNEC), and 36 with small cell carcinoma (SCC). STAS was defined as the presence of floating tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. STAS was classified as grade 1 or 2 depending on whether it was found within or beyond one ×10 objective lens field away from the main tumor margin, respectively. Results: Fifty-four patients (70%) had STAS, including 22% with TC, 50% with AC, 69% with LCNEC, and 86% with SCC. Patients with STAS had more nodal metastasis, lymphatic and vascular invasion, tumor necrosis, and tumor subtypes other than TC. Among STAS cases, grade 2 STAS was present in 33% of AC, 78% of LCNEC, and 87% of SCC. The 5-year recurrence-free survival (RFS) rate was 81%, 63%, and 35% in patients with no STAS, grade 1, and grade 2 STAS, respectively. Multivariate analysis found that grade 2 STAS was an independent negative prognostic factor for RFS. Conclusion: Although STAS itself was not associated with a poor prognosis, grade 2 STAS was an independent negative prognostic factor for RFS.

• Journal of Chest Surgery
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• 제34권11호
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• pp.887-890
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• 2001

흉선에 발생하는 신경내분비 종양은 매우 드문 질환으로 재발이나 전이가 많아 예후가 좋지 못하다. 절반에서 내분비 증상을 보이며, 이 중 33%에서 쿠싱 증후군을 동반한다. 치료로는 수술적 절제가 우선이며, 방사선 치료나 항암치료는 아직 논란의 여지가 많다. 저자들은 쿠싱 증후군을 동반한 흉선의 신경내분비 종양 2례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 한국임상수의학회지
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• 제27권2호
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• pp.186-189
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• 2010

14년 령의 암컷 치와와견이 발작증세 및 좌측으로의 선회운동 증상을 보여 내원하였다. 신경검사결과 좌측 대뇌 병변이 의심되어 자기공명영상 촬영을 실시하여 좌측 비강에서 좌측 대뇌로 파급된 병변을 확인하였다. 영상 분석 상에서 비강 내에서 유래된 2차적인 뇌종양이 강력하게 의심되었다. 환자의 증상은 프레드니솔론과 로무스틴의 혼합치료 후 상당히 개선되었고 진단 후 2개월간 생존하였다. 조직 검사 결과 비강에서 유래한 신경내분비암종으로 확진되었다. 본 증례보고는 개에서 발생한 비강유래 신경내분비암종의 침윤에 의한 2차적인 뇌종양의 임상적인 특징, 영상 진단 결과, 그리고 조직학적인 특성을 잘 보여주고 있다.

• Journal of Digestive Cancer Reports
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• 제9권2호
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• pp.57-59
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• 2021

Carcinoid tumor is called as neuroendocrine tumor and is classified into neuroendocrine tumor Grade 1, neuroendocrine tumor Grade 2, and neuroendocrine carcinoma based on the differentiation of tumors. Recently, the incidence of rectal carcinoid tumor has been increasing probably due to the increased interest on screening colonoscopy and the advancement of endoscopic imaging technology. As the rectal carcinoid shows a wide range of clinical characteristics such as metastasis and long-term prognosis depending on the size and histologic features, it is a challenge to give a consistent diagnostic code in patients with the rectal carcinoid. If the rectal carcinoid tumor is less than 1 cm in size, it can be given as the code of definite malignancy or the code of uncertain malignant potential according to International Classification of Diseases for Oncology (ICD-O) by World Health Organization (WHO). Because patients get different amount of benefit from the insurance company based on different diagnostic codes, this inconsistent coding system has caused a significant confusion in the clinical practice. In 2019, WHO updated ICD-O and Statistics Korea subsequently changed Korean Standard Classification of Diseases (KCD) including the code of rectal carcinoid tumors. This review will summarize what has been changed in recent ICD-O and KCD system regarding the rectal carcinoid tumor and surmise its clinical implication.

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.50-54
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• 2017

Pancreatic neuroendocrine tumors are rare pancreatic neoplasms comprising 1-2% of all pancreatic tumors and typically present high attenuating mass on arterial and venous phase images, due to their rich capillary network. A 70-year-old South Korean female visited our hospital presenting with jaundice and dark urine color. She had received an operation for treatment of small bowel perforation seven years ago. On physical examination, icteric sclera was observed but otherwise unremarkable. Laboratory tests were abnormal liver function test and suspected obstructive jaundice. Computed tomography revealed 4 cm sized cystic mass lesion with homogeneous low attenuation in the head of pancreas and distal common bile duct was compressed by the mass. During review of past medical records, we found that the mass was observed and measured about 1.7 cm seven years ago. To resolve obstructive jaundice, pylorus preserving pancreaticoduodenectomy was performed and diagnosed with well differentiated pancreatic neuroendocrine carcinoma with intermediate grade.